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P Gjerden

Publications and source records attributed to P Gjerden.

5 recordsLinked to original sources

Patient satisfaction and ward atmosphere during a crisis in an open psychiatric ward.

BACKGROUND: There is great need for useful indicators of quality of care for inpatient psychiatric treatment. The study examines whether patient satisfaction and ward atmosphere can be used as a means of evaluating an assumed decline in quality of care during a crisis in an open psychiatric ward. METHODS: Twice a year for 2 years ten patients filled out a standardized patient satisfaction questionnaire developed by the Swedish Institute for Health Services Development (SPRI) on their day of departure. At the same time all the patients in the ward evaluated the ward atmosphere using the Ward Atmosphere Scale (WAS). In the third study period the ward went through a crisis where quality of care was expected to be lower. RESULTS: The SPRI questionnaire confirmed the decline in patients' perceived quality of care on six of 41 questions, WAS was markedly lower on five of ten subscales. CONCLUSIONS: Both WAS and the SPRI questionnaire gave useful information on how the ward was affected by the crisis. WAS seemed to be a more sensitive way of measuring quality of care, while the SPRI questionnaire indicated more clearly the practical consequences.

Alcoholism↗

Orphenadrine.

Explore the source record for details and available documents.

Antidepressive Agents↗

[Fatalities caused by anticholinergic antiparkinsonian drugs. Analysis of findings in a 11-year national material].

All autopsy samples received at the National Institute of Forensic Toxicology during the years 1986-1996 which contained anticholinergic antiparkinsonian drugs were reviewed. Of a total of 69 cases, orphenadrine was present in 57 (83%), biperiden in 8 (12%), procyclidine in 3 (4%), and trihexyphenidyl/benzhexol in 1 (1%) of the subjects. The measured concentrations were assessed in light of previously published data. Of 21 cases where causality between drug ingestion and death was classified as either highly probable (18/21) or possible (3/21), all subjects tested positive for orphenadrine. In the autopsy samples from these patients, orphenadrine concentrations in the 4.5-600 mumol/l range (mean 62.5 mumol/l, SD 126.5 mumol/l) were determined. Because of a low national autopsy rate, there is reason to believe that the actual numbers of drug-related deaths in this period may have been significantly higher. It is concluded that orphenadrine is responsible for a disproportionally high number of overdose deaths.

Adolescent↗

[Clinical pharmacology of anticholinergic antiparkinson agents. A review with emphasis on acute toxicity].

Today, anticholinergic antiparkinsonian drugs are primarily used to ameliorate extrapyramidal side-effects induced by neuroleptic agents. Orphenadrine dominates quantitatively among these drugs in Norway, presumably because it is assumed to carry a lower risk of abuse. There are numerous reports of deaths following orphenadrine overdoses. Orphenadrine has complex pharmacokinetic properties and a narrow therapeutic index. After an overdose, it confers toxic effects of rapid onset to several organ systems. No specific and effective therapy for orphenadrine intoxication has been established. For the two other drugs in this class which are marketed in Norway, biperiden and benztropine, toxicity is mainly connected to their anticholinergic properties. Notably, no reports of lethalities after overdoses of biperiden seem to be available. A small number of accounts of deaths following benztropine intoxication have been published. Neither of these two agents, and benztropine in particular, has been subjected to comprehensive pharmacokinetic evaluations. The relatively extensive use of orphenadrine should be discouraged.

Antiparkinson Agents↗