Izazovi u liječenju bipolarno afektivnog poremećaja

master's thesis

• Title (english): Challenges in treatment of bipolar affective disorder
• Author: Ivana Grigić
• Mentor: Lidija Bach-Rojecky (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Committee member: Živka Juričić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2016-03-24, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Glavni cilj ovog diplomskog rada bio je prikazati izazove u liječenju bipolarno-afektivnog poremećaja (BAP), kao
jednog od čestih mentalnih poremećaja s visokim stupnjem onesposobljenja oboljelih. Specifični ciljevi bili su: opisati
kliničku sliku bipolarno afektivnog poremećaja, ukazati na važnost prepoznavanja simptoma te ranog i ispravnog
dijagnosticiranja bolesti, farmakološki okarakterizirati skupine lijekova koje se najviše koriste u liječenju, te obradom
slučaja iz prakse ukazati na osnovne terapijske probleme.
U radu je opisan farmakološki profil osnovnih skupina lijekova koji se koriste za liječenje bipolarnog poremećaja.
Među njima, stabilizatori raspoloženja predstavljaju temeljnu terapiju, a koriste se još antipsihotici te antidepresivi.
Stabilizatori raspoloženja međusobno se razlikuju po djelotvornosti u pojedinim fazama BAP-a, kao i po
podnošljivosti i interakcijama s drugim lijekovima. Litij i valproati djelotvorni su i u liječenju akutne faze bolesti i u
terapiji održavanja. Također, psihoterapija i psihoedukacija su od iznimne važnosti za bolesnika i bolesnikovu obitelj.
Nužno je da pacijent i njegova obitelj razumiju važnost pridržavanja terapije i prepoznaju rane znakove manije i
depresije.
Pokušaji suicida i izvršeni suicidi česte su tragične manifestacije u osoba oboljelih od bipolarnog afektivnog
poremećaja. Tijekom zadnjeg desetljeća, rizični faktori suicidalnog ponašanja značajno se istražuju. Rezultati
istraživanja pokazuju kako su obiteljska i osobna anamneza suicidalnog ponašanja, zlostavljanje u djetinjstvu, i
komorbiditetni faktori povezani s rizikom suicidalnih pokušaja i izvršenih suicida.Farmaceut ima važnu i odgovornu
ulogu u provođenju skrbi o bolesnicima s bipolarnim afektivnim poremećajem. Kao najdostupniji zdravstven djelatnik,
u prilici je kontrolirati farmakoterapiju i savjetovati o njenom racionalnom provođenju, ali i kroz razvijen povjerljiv
odnos s pacijentom, utjecati na adherenciju te tako doprinjeti postizanju željenog terapijskog cilja s minimalnim
rizicima od neželjenih i toksičnih učinaka.

Abstract (english)

The main aim of this thesis was to present challenges in the treatment of bipolar-affective disorder (BAP), as one of
the most common mental disorders with a high degree of disability of patients. Specific aims were: to describe the
clinical picture of bipolar affective disorder, point out the importance of recognizing symptoms and early and correct
diagnosis, pharmacologically characterize the group of drugs that are most commonly used in the treatment and by the
presentation of the case study demonstrate the basic therapeutic problems.
This paper describes the pharmacological profile of the basic groups of drugs used to treat bipolar disorder. Among
them, mood stabilizers are today the main therapy for this psychiatric condition, but antipsychotics and antidepressants
are also used. There is a spectrum of activity across different mood stabilizers, with some being more effective for the
treatment of manic episodes and others for the treatment of depressive phase. They also differ in tolerability profiles
and potency for drug interactions. Lithium and valproates are both effective in treating acute phase of the disease and
used for maintenance treatment. Also, psychotherapy and psychoeducation are of great importance for the patient and
the patient's family. It is critical that the patient and the patient’s family understand and recognize the importance of
medication compliance and the early signs of mania and depression. Attempted and completed suicide is a frequent
and most serious consequence of bipolar disorder. In the last decade, a considerable progress has been made in the
investigation of risk factors associated with suicidal tendencies. Evidence indicates that family and personal history of
suicidal behaviour, childhood abuse and comorbidity are the factors associated with attempted and completed suicide.
The pharmacist has an important and responsible role in providing optimal care for patients with bipolar affective
disorder. As the most accessible health care provider, pharmacist is able to control pharmacotherapy and advise on its
rational implementation, but also through confidential relationship with the patient, influence the adherence and thus
contribute to achieving therapeutic goal with minimal risks of unwanted and toxic side effects.

• Keywords: bipolarni afektivni poremećaj; stabilizatori raspoloženja; antipsihotici; antidepresivi; psihoterapija; suicid
• Keywords (english): bipolar affective disorder; mood stabilizers; antipsychotics; antidepressants; psychotherapy treatment; suicide
• Language: croatian
• URN:NBN: urn:nbn:hr:163:634897
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2016-06-16 15:33:59