this post was submitted on 21 Jun 2024
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Medicine

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[–] [email protected] 7 points 6 days ago* (last edited 6 days ago) (2 children)

q6months? Current long acting injectable birth control lasts like 3 months and antipsychotics are sometimes lucky to last 1! (After researching the existing PrEP LAI, it looks like it usually lasts 1-2 months) 6 months is some hella staying power. I shudder to think what having an antiviral in you for 6 months at a time does to your liver long-term, but I suppose it can't be worse than full compliance with the pill. Wonder if I'll be giving this in a few years (LAIs are usually a dayshift problem though). There's good odds psych has the most sex workers in the hospital, it turns out people who can't reliably name an abuser are really easy to traffic to all kinds of ends.

[–] [email protected] 7 points 6 days ago (1 children)

I mean, they have year long heartworm shots. It's not like it's unheard of for an injectable to last longer than a few months.

[–] [email protected] 2 points 6 days ago* (last edited 6 days ago)

Well to me that can go a couple different ways. I realize I forgot to clarify above that my knowledge of meds outside of psych drugs fades pretty quickly beyond the easy ones like metoprolol and pantoprazole, so I can't really speak to the specifics from the back end of drug testing and approval of long acting medications from other drug families without a lot more reading that I am not doing on my day off (it was my least favorite class the better part of a decade ago).

On the other hand I could absolutely see an IM med being approved at a higher relative dosage and/or with a slightly harsher side effect profile in veterinary medicine even if just to reduce occupational dog bites by increasing the time interval. That could also just be empathy for someone who has had to stab an actively struggling patient (and been the reluctant stab-ee myself believe it or not).

[–] stoly 4 points 6 days ago* (last edited 6 days ago) (1 children)

And the scary part: if there's an unfortunate side effect for you, you're not getting away from it for half a year. It apparently happens with the injectable long term psychiatric drugs that someone just gets stuck suffering for months on end if that particular drug does not agree with their system.

[–] [email protected] 3 points 6 days ago* (last edited 6 days ago)

Yuuuup. We try to give them by mouth first to check for those kinds of things, but sometimes

  1. they're just missed. I came in one week and got my same patient back and they'd had EPS for the almost entire time I'd been gone and nobody noticed because (aside from the drug being the lowest risk antipsychotic for EPS) the patient was complaining their teeth hurt and nobody made the connection it was because the EPS had been making them grind them! I only checked because I've had EPS before so cogwheeling is like the first thing I check for (after the big stuff like heart attacks and strokes obvs) for any complaint involving the head neck or arms. (I've heard everything from "my tongue feels too big" to "I'm blinking too much" to "the aliens implanted a chip in my neck" and "my arms have gone numb" that all presented with cogwheeling and were cured by benadryl or benztropine!) If I hadn't by chance had that one weird professional quirk and also been assigned to that specific patient no one would have known.

  2. Sometimes the horrible side effect drug is the only thing that stops them from throwing literal fucking haymakers multiple times a day, so you just pile on more meds to try to control the side effects and... pray. No joke, farm kids on meth are hell. All that strength and not a lick of sense or reason left.

[–] [email protected] 4 points 6 days ago

Is it common for a medicine to be 100% effective? That seems weird to me.