Restricted accessCase reportFirst published online 2020-6
Pharmacist-Initiated Management of a Suspected Case of Risperidone-Induced Neuroleptic Malignant Syndrome in an Aged-Care Resident. The Role of Residential Medication Management Reviews in Medication Safety
A 70-year-old female aged-care resident was referred by her general practitioner for a residential medication management review after nurses reported difficulties with swallowing, episodes of hyperthermia, elevated blood pressure, and tachycardia. These symptoms were accompanied by increasing confusion and drowsiness. Risperidone had recently been prescribed to treat behavioral and psychological symptoms of dementia. This case study describes the pharmacist-initiated management of the symptoms through a national medication review program. It demonstrates the valuable role collaborative medication reviews play in managing adverse drug reactions in aged-care.
PileggiDJCookAM. Neuroleptic malignant syndrome: focus on treatment and rechallenge. Ann Pharmacother. 2016;50(11):973–981.
3.
TseLBarrAMScarapicchiaVVila-RodriguezF. Neuroleptic malignant syndrome: a review from a clinically oriented perspective. Curr Neuropharmacol. 2015;13(3):395–406.
4.
ReulbachUDütschCBiermannT, et al.Managing an effective treatment for neuroleptic malignant syndrome. Crit Care. 2007;11(1):R4.
5.
Antai-OtongD. Pharmacological management of psychosis in Alzheimer’s disease: clinical challenges associated with second-generation antipsychotic medications. Perspect Psychiatr Care. 2008;44(2):120–123.
6.
WestburyJGeePLingTKitsosAPetersonG. More action needed: psychotropic prescribing in Australian residential aged care. Aust N Z J Psychiatry. 2019;53(2):136–147. doi:10.1177/0004867418758919.
Australian Institute of Health and Welfare. Dementia among Aged Care Residents: First Information from the Aged Care Funding Instrument. Aged care statistics series no. 32 Cat. no. AGE 63. Canberra, Australia: AIHW; 2011.
ChenTF. Pharmacist-led home medicines review and residential medication management review: the Australian model. Drugs Aging. 2016;33(3):199–204.
13.
NishtalaPSHilmerSNMcLachlanAJHannanPJChenTF. Impact of residential medication management reviews on drug burden index in aged care homes. Drugs Aging. 2009;26(8):677–686.
14.
DwyerRGabbeBStoelwinderJLowthianJ. A systematic review of outcomes following emergency transfer to hospital for residents of aged care. Age Ageing. 2014;43(6):759–766.
15.
NaranjoCABustoUSellersEM, et al.A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–245.
16.
National Institutes of Health. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda, MD: U.S. National Library of Medicine; 2017. https://livertox.nih.gov/Narajo.html.
17.
FrawleyJFinney-BrownT. Writing for publication: case studies. Australian Journal of Herbal Medicine. 2013;25(3):1–3.
