Primjena antipsihotika u monoterapiji i politerapiji u liječenju shizofrenije

professional thesis

• Author: Maja Đivanović
• Mentor: Miroslav Herceg (mentor)
• Committee member: Miroslav Herceg (predsjednik povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2022, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Cilj istraživanja: Cilj ovog rada je utvrditi učinkovitost, prednosti i nedostatke korištenja
antipsihotika u politerapiji u odnosu na monoterapiju te se osvrnuti na važnost uloge koju
ljekarnici, kao najdostupniji zdravstveni djelatnici, mogu imati u liječenju shizofrenije i
primjeni antipsihotika.
Ispitanici i metode: U tu svrhu napravljen je sustavni i retrospektivni pregled znanstvene i
stručne literature, pretražene su trenutno važeće terapijske smjernice, publikacije stručnih
udruga i institucija, baza lijekova Agencije za lijekove i medicinske proizvode te drugi
raspoloživi izvori.
Rezultati: Identificirane su najčešće kombinacije antipsihotika i podijeljene su na one koje
uključuju klozapin i one bez njega. Istaknute su prednosti i nedostatci svake pojedine
kombinacije. Naglašena je važnost uključivanja javnih ljekarnika
Zaključak: Politerapija je jedino ispravno rješenje uslijed više neadekvatnih terapijskih
pokušaja monoterapijom, ali se u kliničkoj praksi ipak ona uključuje puno prije, usprkos
preporukama svih važećih smjernica. Zbog premalo kvalitetnih, randomiziranih studija
prednost ipak treba dati monoterapiji, a uslijed kombiniranja antipsihotika treba pažljivo
pratiti pacijenta kako bi prednosti kombinacije nadmašili rizik dodatnih nuspojava i
povećanog troška liječenja. Javni ljekarnici mogu imati veliku ulogu u poboljšanju
adherencije, a upravo neadherencija predstavlja jedan od najčešćih problema u liječenju
shizofrenije. Uloga javnih ljekarnika u tome je trenutno premalo iskorištena te su nužne
dodatne edukacije i angažman struke kako bi se to promijenilo na koristi preopterećenog
zdravstvenog sustava.

Abstract (english)

Aim: The aim of this paper is to determine the efficacy, advantages, and disadvantages of
using antipsychotics in polytherapy in relation to monotherapy and to look at the importance
of the role pharmacists, as the most accessible healthcare professionals, can play in treating
schizophrenia and antipsychotics.
Subjects and method: For the purposes of this research, a systematic and retrospective
review of scientific and professional literature was made. Currently valid therapeutic
guidelines, publications of professional associations and institutions, the drug database of the
Agency for Medicinal Products and Medical Devices and other available sources were
researched.
Results: The most common combinations of antipsychotics were identified and separated into
those that include clozapine and those that do not. The advantages and disadvantages of each
combination were highlighted. The importance of involving public pharmacists was
emphasized.
Conclusion: Polytherapy is the only viable solution if all other therapy attempts have
consistently proven inadequate, however, in clinical practice polytherapy is still introduced
much earlier despite the recommendations of all leading guidelines. Due to insufficient quality
of randomized studies, preference should be given to monotherapy treatment. If preference is
in fact given to polytherapy, the patient should be closely monitored so that the benefits of the
combination outweigh the risk of additional side effects and increased treatment costs. Public
pharmacists can play a major role in improving adherence, and it is exactly non-adherence
that is one of the most common problems in the treatment of schizophrenia. Currently, the
role of public pharmacists is underutilized and additional training and engagement of the
profession is needed to make changes that will benefit an overburdened health system.

• Keywords: shizofrenia; antipsihotici; monoterapija; politerapija; uloga ljekarnika
• Keywords (english): schizophrenia; antipsychotics; monoterapija; politerapija; pharmacists' role
• Language: croatian
• URN:NBN: urn:nbn:hr:163:477893
• Study programme: Title: Clinical pharmacy; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/sveučilišna magistra kliničke farmacije (sveučilišni/a magistar/sveučilišna magistra kliničke farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-17 13:33:44