Pharmacist intervention to detect drug adverse events on admission to the emergency department: Two case reports of neuroleptic malignant syndrome

Summary What is known and objective Neuroleptic malignant syndrome (NMS) is a rare but severe adverse effect of antipsychotic drugs. Case description We report two cases of NMS highlighted by clinical pharmacists in an emergency unit during summer. One of them was fatal. Medication reconciliation pr...

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Bibliographic Details
Published in:	Journal of clinical pharmacy and therapeutics Vol. 42; no. 4; pp. 502 - 505
Main Authors:	Leenhardt, F., Perier, D., Pinzani, V., Giraud, I., Villiet, M., Castet‐Nicolas, A., Gourhant, V., Breuker, C.
Format:	Journal Article
Language:	English
Published:	England Hindawi Limited 01-08-2017 Wiley
Subjects:	accident and emergency departments adverse effect Aged Antipsychotic Agents - administration & dosage Antipsychotic Agents - adverse effects Antipsychotics Case reports clinical pharmacy Clozapine Clozapine - administration & dosage Clozapine - adverse effects Emergency medical services Emergency Service, Hospital - organization & administration Fatal Outcome Humans Life Sciences loxapine Loxapine - administration & dosage Loxapine - adverse effects Male Middle Aged Neuroleptic Malignant Syndrome - diagnosis Neuroleptic Malignant Syndrome - etiology pharmacist consultation Pharmacists Pharmacists - organization & administration Pharmacy Service, Hospital - organization & administration Professional Role clozapine clinical pharmacy adverse effect pharmacist consultation accident and emergency departments loxapine
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Summary:	Summary What is known and objective Neuroleptic malignant syndrome (NMS) is a rare but severe adverse effect of antipsychotic drugs. Case description We report two cases of NMS highlighted by clinical pharmacists in an emergency unit during summer. One of them was fatal. Medication reconciliation processes performed at admission identified treatment with loxapine for one of them and with loxapine and clozapine for the other. Interview of the patients highlighted clinical symptoms suggesting NMS, allowing the pharmacists to alert the medical team. What is new and conclusion Adverse drug events may be severe and clinical pharmacists in emergency departments can help to detect them. At the university hospital of Montpellier in France a pharmaceutical team is present in the Emergency‐Department to detect hospital admissions caused by iatrogenic events. We report 2 cases of neuroleptic malignant syndrome (NMS), including one fatal, highlighted by clinical pharmacists during heatwave. Adverse events may be severe and clinical pharmacists are of interest in emergency departments to detect them.
ISSN:	0269-4727 1365-2710
DOI:	10.1111/jcpt.12531