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CPD: Central nervous system

Neuron

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Articles here relate to the central nervous system and reflect chapter four of the British National Formulary

 

 

 

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Dependence on benzodiazepines or Z-drugs: having that conversation

October 2012

Many patients take benzodiazepines or Z-drugs for longer than recommended. Do you have the background information to explain the benefits of reviewing treatment?

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Multiple sclerosis treatment options

February 2012

An article presents an overview of disease management, including the use of recently launched medicines.  

 

Support for people who are traumatised

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September 2011

Understanding post traumatic stress disorder will help you support those

who have been disturbed by a traumatic event


Stroke: long-term management

July 2011

Lifelong Learning

Dry mouth, depression and spasticity are common sequelae of stroke. Managing these problems and preventing further vascular events are the main considerations in the long-term care of stroke patients


Stroke: acute management

July 2011

Time is of the essence when treating stroke. Therefore, patients should be transferred immediately to a hyperacute

Lifelong Learning

stroke unit for management, which will depend on the type and severity of the stroke


Stroke: classification and diagnosis

July 2011

Slurred speech, facial droop and arm

Lifelong Learning

weakness — it is critical that all healthcare professionals are alert for these signs of stroke to ensure that patients displaying them receive treatment quickly

 

Epilepsy: review what you know (part 2)

June 2011

This second part of an article on epilepsy looks at

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special considerations and counselling needed for certain groups of patients

 

 

Epilepsy: review what you know (part 1)

June 2011

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Sudden unexpected death in epilepsy is estimated to account for 500 deaths a year in the UK so effective treatment to prevent seizures is important. This article reviews the management of epilepsy and how pharmacists can support patients

 

Lifelong Learning

Schizophrenia: clinical features and diagnosis

February 2011

Schizophrenia is a chronic mental health condition characterised by a distortion of perceptions and thinking. It is thought to be caused by a combination of biological, social and psychological factors

Lifelong Learning

Schizophrenia: long-term management

February 2011

Although effective for the treatment of schizophrenia, antipsychotics have considerable adverse effects, ranging from the metabolic syndrome to extrapyramidal reactions — striking a balance can be tough

 

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Helping cancer patients in the community

February 2011

Cancer patients are spending more time out of hospital and in the community. Steve Williamson describes cancer services in the UK and looks at how community pharmacists can support those undergoing treatment

 

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Parkinson’s disease therapy update

September 2010

Although our understanding has increased since features of Parkinson’s disease were first described almost 200 years ago, a cure remains elusive. Treatments and recommendations for management are outlined by Mohmadshakil Kathawala 

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Delirium: a guide to a common condition

August 2010

Delirium is not a benign condition — its presence predicts significantly increased morbidity and mortality, often in already vulnerable patient groups. Mark Borthwick and Nina Barnett give an overview of delirium, its prevention, detection and treatment, highlight the latest NICE guidance, and suggest a role for pharmacists

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Understanding bipolar disorder

April 2010

Bipolar disorder is a distressing mental illness involving extreme fluctuations of mood. Stephen Bleakley and Rebecca Henry explain how this condition, which affects around one in 100 people, is managed

 

Lifelong Learning

Epilepsy: Clinical features and diagnosis

March 2010 (Clinical Pharmacist)

When an individual experiences a seizure it is important to identify the underlying cause. Repeated seizures may constitute a diagnosis of epilepsy. The type of seizures will dictate how the epilepsy is treated

 

Lifelong Learning

Epilepsy: Pharmacological treatment and monitoring

March 2010 (Clinical Pharmacist)

Although treatment with antiepileptic drugs can stop seizures recurring, close monitoring of side effects is crucial

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Understanding essential tremor

March 2010

Most readers will probably think of Parkinson’s disease if tremor is mentioned but essential tremor should be a more likely association. Navjot Nannar looks at this condition, treatment options and advice

 

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Treatments for patients with schizophrenia

July 2009

Stephen Bleakley and Marion Wetherill give an overview of current treatment options and guidelines for schizophrenia

 

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The management of depression

March 2009

In Western Europe depression affects between 5 and 10 per cent of the population and it is currently ranked as the third leading contributor to the global burden of disease. Stephen Bleakley gives an overview of the condition and its treatment

Lifelong Learning

Clinical focus: bipolar affective disorder

February 2009

Around a third of individuals who commit suicide have bipolar affective disorder. Three Clinical focus articles discuss the diagnosis and treatment of this debilitating condition

 

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How to encourage smoking cessation

February 2009

As public attitudes towards smoking change, it has been argued that people who remain smokers are those who are the most addicted. Andrew McCoig gives tips for engaging new clients and re-engaging those who have failed previous attempts to give up

Omega-3 fatty acid no better than placebo in Huntington’s disease (POEM)

February 2009

Does ethyl-eicosapentaenoic acid, an omega-3 fatty acid, improve motor function in patients with Huntington’s disease?

Ulcerative colitis and nicotine

January 2009

I’ve got ulcerative colitis and have heard that nicotine has been used to treat it, but I don’t smoke. In fact, I hate cigarette smoke. What do you suggest?

Antipsychotics and stroke: the story to date (Adverse drug reactions)

January 2009

Both “conventional” antipsychotics and the newer “atypical” antipsychotics are dopamine receptor antagonists. However, the atypical antipsychotics are associated with fewer neurological (and some other) side effects

Nicotine gum for pregnant smokers increases birth weight (POEM)

January 2009

Clinical question: Is nicotine gum safe and effective for smoking cessation in pregnancy and does it lead to better outcomes for infants?

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Personalising OTC analgesia

December 2008

In the second part of an article on over-the-counter analgesics, Andrew Dickman discusses the precautions and special considerations needed in order to recommend a product and ensure appropriate use

 

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Choosing over-the-counter analgesics

November 2008

According to the Proprietary Association of Great Britain, 2007 sales of analgesics reached £526m, making up 23 per cent of all OTC sales. There are numerous products available, but which can be recommended? Andrew Dickman reviews the situation in two articles. The first, published here, focuses on the drugs. The second looks at cautions, contraindications and other considerations

Drug interactions: Interactions between fentanyl and drugs that inhibit CYP3A4

November 2008

A theoretical patient, Mr X is has been taking morphine up to 100mg daily for cancer-related pain but, since his pain is still not properly controlled, a transdermal fentanyl patch is prescribed at a dose of 25µg/h. He has a past medical history of angina, high blood pressure and osteoarthritis, and his long-term medication includes aspirin, simvastatin, ramipril, diltiazem, isosorbide mononitrate and glucosamine/chondroitin

Bariatric surgery

Two Life-long learning articles: A summary of current practice; Prescribing issues

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An overview of anxiety disorders

October 2008

Stephen Bleakley outlines different types of anxiety disorders and explores therapies that can reduce suffering and prevent distress

 

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Unravelling the mystery of ADHD


February 2008

Samixa Shah gives an overview of attention deficit hyperactivity disorder and its current drug treatment


 

 

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Understanding Alzheimer’s disease

November 2006

It has been 100 years since the features of Alzheimer’s disease were first described. Since then our understanding of it has increased
but there is still no cure. Alan Worsley and Andrew Husband outline how the disease is currently managed


Different types of dementia

November 2006

Andrew Husband and Alan Worsley describe some different dementias and their treatments


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OTC advice on travel sickness

April 2006

Travel (motion) sickness is a condition for which pharmacists are frequently asked to provide advice and to recommend preventive treatment. All medicines licensed for this indication are pharmacy medicines so pharmacists have good options to offer

Sleep and sleeping disorders

February 2005

Although we have come a long way since Edgar Allen Poe described sleep as “little slices of death”, there are still many gaps in our understanding of it and its functions. Three articles look at aspects of sleep and health.

Can hangovers be prevented or cured

December 2004

Pam Mason takes a look at some old and new hangover remedies and the theories behind how they might work

Dealing with cases of hiccups

October 2004

Although almost everyone has experienced hiccups, little is known about their cause or significance

Bipolar disorder

April 2004

Bipolar disorder is characterised by recurrent manic or hypomanic and depressive episodes. The first part of this special feature describes the clinical features, epidemiology, aetiology, diagnosis and pathophysiology of the disorder. The aim of drug treatment in bipolar disorder is to manage acute episodes of mania, hypomania and depression and, in the longer term, prevent relapse. The second article reviews the medicines available and sets out the pharmaceutical care issues that can improve patient compliance and, therefore, clinical outcomes

Parkinson's disease

January 2004

Parkinson’s disease is a relatively common neurodegenerative disease, which mainly affects the elderly. The first part of this special feature looks at clinical symptoms, the genetic basis of Parkinson’s disease, and diagnostic issues, including distinguishing the idiopathic illness from other conditions producing parkinsonism. The treatment of Parkinson’s disease focuses on controlling symptoms and managing the complications of the drugs used. The second article discusses current strategies and looks at some possible future developments that could potentially stop the degenerative process.

Alcohol misuse — a case study

December 2003

Research conducted this year by the charity Turning Point indicated that 3.8 million people in England and Wales (three million men and 800,000 women) are dependent on alcohol. Every day 13 people die as a result of alcohol misuse.

Epilepsy

July 2003

Epilepsy is one of the most common neurological conditions. These articles discuss the classification of seizures, the cellular and genetic basis of epilepsy and some of the known causes of the condition, current anti-epileptic drugs, possible therapeutic developments and the opportunities for clinical pharmacists to improve medicines management in patients with epilepsy

Multiple sclerosis

January 2003

In the first part, the authors outline the genetic and viral factors involved in the aetiology of multiple sclerosis along with the use of an animal model that provides an insight into the pathogenesis of the disease The second part discusses pharmacological approaches to the treatment of multiple sclerosis and its symptoms

Clinical depression

September 2002

Clinical depression affects one in five people at some time in their lives. The first part of this special feature on depression, discusses its causes, symptoms and pathology. Antidepressants are the mainstay of treatment for clinical depression, but which one suits which circumstances? The second part of this special feature looks at the options. The final part considers the association between alcohol dependence and clinical depression, as well as the treatment of depression in alcoholics

Herbal therapeutics (5) Insomnia

August 2002

This article considers evidence for the efficacy and safety of herbal medicines used traditionally to aid sleep

Herbal therapeutics (3) Cognitive deficiency and dementia

August 2002
This article considers the evidence for the efficacy and safety of Ginkgo biloba

Herbal therapeutics (2) Depression

June 2002
It has been estimated that one in five people will suffer from depression at some time during their lives. St John’s wort is prescribable and some people may ask your advice on purchasing herbal remedies for depression. This article looks at the evidence for using herbal products to treat depression

Getting to grips with obesity

May 2002

A series of four articles on obesity and ways it can be tackled

Headache

February 2002
Three articles that consider diferent manifestations of head pain

Motor neurone disease

November 2001

Two articles that describe the clinical features and diagnostic criteria and pathogenesis of motor neurone disease and its management

Pharmaceutical care (14) Parkinson's disease

September 2001

This article discusses the clinical features, diagnosis, treatment and individual patient care of people with Parkinson’s disease

Schizophrenia

July 2001

Around the world, twenty million people are afflicted with schizophrenia. This special feature discusses the biochemical changes that occur in this disease and drugs in current use for the condition

Autism – How dietary interventions could ameliorate the symptoms of autism

July 2001

There has been persistent scepticism, even outright hostility, within the medical establishment to the idea that the symptoms of autism can be affected by diet. However, evidence supporting the efficacy of dietary interventions is accumulating, and pharmacists may be asked to offer a scientific explanation as to how changes to diet could help

Pharmaceutical care (13) Mood disorders: Bipolar conditions

June 2001

In this, the last of three articles on mood disorders, the treatment of bipolar disorders is considered. Previous articles addressed the implications of mood disorders for primary care and the treatment of depression

Dementia

February 2001

The authors discuss the commonest forms of dementia seen in clinical practice and the treatment options available

Psychiatric disorders associated with alcohol misuse

October 2000

The second part of a special feature dealing with the diagnosis and treatment of psychiatric disorders associated with the misuse of alcohol