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Articles here relate to the central nervous system and reflect chapter four of the British National Formulary
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
Understanding post traumatic stress disorder will help you support those
who have been disturbed by a traumatic event
Stroke: long-term management
July 2011
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 2011Time is of the essence when treating stroke. Therefore, patients should be transferred immediately to a hyperacute
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
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 2011This second part of an article on epilepsy looks at
special considerations and counselling needed for certain groups of patients
Epilepsy: review what you know (part 1)
June 2011Sudden 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
Schizophrenia: clinical features and diagnosis
February 2011Schizophrenia 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
Schizophrenia: long-term management
February 2011Although 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
Helping cancer patients in the community
February 2011Cancer 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
Parkinson’s disease therapy update
September 2010Although 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
Delirium: a guide to a common condition
August 2010Delirium 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
Understanding bipolar disorder
April 2010Bipolar 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
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
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
Understanding essential tremor
March 2010Most 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
Treatments for patients with schizophrenia
July 2009Stephen Bleakley and Marion Wetherill give an overview of current treatment options and guidelines for schizophrenia
The management of depression
March 2009In 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
Clinical focus: bipolar affective disorder
February 2009Around a third of individuals who commit suicide have bipolar affective disorder. Three Clinical focus articles discuss the diagnosis and treatment of this debilitating condition
How to encourage smoking cessation
February 2009As 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 2009Does ethyl-eicosapentaenoic acid, an omega-3 fatty acid, improve motor function in patients with Huntington’s disease?
Ulcerative colitis and nicotine
January 2009I’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 2009Clinical question: Is nicotine gum safe and effective for smoking cessation in pregnancy and does it lead to better outcomes for infants?
Personalising OTC analgesia
December 2008In 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
Choosing over-the-counter analgesics
November 2008According 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 2008A 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
An overview of anxiety disorders
October 2008Stephen Bleakley outlines different types of anxiety disorders and explores therapies that can reduce suffering and prevent distress
Unravelling the mystery of ADHD
February 2008Samixa Shah gives an overview of attention deficit hyperactivity disorder and its current drug treatment
Understanding Alzheimer’s disease
November 2006It 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 2006Andrew Husband and Alan Worsley describe some different dementias and their treatments
OTC advice on travel sickness
April 2006Travel (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 2005Although 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.
- Sleep and sleeping disorders
- Insomnia and its management
- Snoring and the evidence behind the various treatments available
Can hangovers be prevented or cured
December 2004Pam 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 2004Although almost everyone has experienced hiccups, little is known about their cause or significance
Bipolar disorder
April 2004Bipolar 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 2004Parkinson’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.
- Parkinson's disease - clinical features, pathophysiology and genetics
- Parkinson's disease - current and future aspects of drug treatments
Alcohol misuse — a case study
December 2003Research 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 2003Epilepsy 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
- Epilepsy - the aetiology and pathogenesis
- Current and future aspects of the drug therapy of epilepsy
Multiple sclerosis
January 2003In 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 2002Clinical 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
- Aetiology and pathology of clinical depression
- Management of clinical depression
- Clinical depression in heavy drinkers of alcohol
Herbal therapeutics (5) Insomnia
August 2002This article considers evidence for the efficacy and safety of herbal medicines used traditionally to aid sleep
Herbal therapeutics (3) Cognitive deficiency and dementia
August 2002This article considers the evidence for the efficacy and safety of Ginkgo biloba
Herbal therapeutics (2) Depression
June 2002It 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 2002A series of four articles on obesity and ways it can be tackled
- (1) Incidence and associated risks
- (2) Non-drug strategies
- (3) Pharmacotherapy
- (4) How pharmacists can contribute to obesity management
Headache
February 2002 Three articles that consider diferent manifestations of head painMotor neurone disease
November 2001Two 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 2001This article discusses the clinical features, diagnosis, treatment and individual patient care of people with Parkinson’s disease
Schizophrenia
July 2001Around 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 2001There 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 2001In 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 2001The authors discuss the commonest forms of dementia seen in clinical practice and the treatment options available
Psychiatric disorders associated with alcohol misuse
October 2000The second part of a special feature dealing with the diagnosis and treatment of psychiatric disorders associated with the misuse of alcohol
