Quantitative critique - Research Paper Example

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Running Head: ARTICLE CRITIQUE: NEW-ONSET Article Critique: New-Onset Type-2 Diabetes Associated with Atypical Antipsychotic Medications Michael T. Lambert, Laurel A. Copeland, Nancy Sampson, and Sonia A. Duffy Progress in Neuro-Psychopharmacology & Biological Psychiatry 30 (2006) 919–923 Instructor Date Article Critique New-Onset Type-2 Diabetes Associated with Atypical Antipsychotic Medications Michael T…
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Download file to see previous pages The authors feel that the distinction between these atypical medications and the comorbidity with weight gain and diabetes is an important distinction. Furthermore, this certainly has ramifications for nursing in regards to the diet and importance of monitoring signs of diabetes and increased weight gain in this cohort. The population under study and the quantitative analysis of the data is appropriate and meaningful for this study. Literature Review: The references cited, while not extensive, are suitable for the size of the study. Twenty-two references are used directly. Of these, seven are directly related to the effects the study is analyzing. The others relate to the specific mediations under study as well as the general information regarding diabetes and adiposity. Twenty are current and date from 2002 forward, only two are older, (1) the American Diabetes Association’s “Report of the expert committee on the diagnosis and classification of diabetes mellitus.” dates from 1997 but is only used as a general reference and (2) Gray and Fujioka (1991) “Use of relative weight and body mass index for the determination of adiposity,” also for general guidelines. ...
In a survey of diabetes associated with clozapine, glycemic control improved after clozapine was stopped in 78% of individuals who developed diabetes; 62% of these patients no longer required hypoglycemic drugs. Of 12 patients who were restarted on clozapine, 9 developed hyperglycemia again. (Cohen, 2004, 3) While other references used generalized this effect there is other literature that directly supports it. For instance, in a study they did not reference, Koller and Doraiswamy (2002) showed in their research that 78% of the group had improved glycemic balance once they stopped taking or decreased the dosage of olanzapine and that if olanzapine was restarted eight out of ten patients had a recurrence of hyperglycemia. So it is clear that there were previous studies which connected the same inferences the authors are stating. There is also some research that counter-indicates their results as to weight gain to some extent: …patients taking antipsychotic drugs can develop diabetes without significant weight gain or can lose weight. Furthermore, their diabetes usually improves rapidly when the antipsychotic drug is withdrawn, without significant reduction in body weight, and often recurs rapidly if the drug is started again. (Wirshing, 2001, 8) They do cite another study from Wirshing, Boyd and Meng (2002) which does concur with their weight gain hypothesis. Furthermore, as far back as 1999, the diabetic inducing effects off clozapine and olanzapine were already known: Several cases of new-onset diabetes attributed to clozapine and olanzapine were associated with acute pancreatitis. It is possible, therefore, that antipsychotic-induced diabetes results from chemical damage to the pancreas. However, diabetes ...Download file to see next pagesRead More
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