Clinical practice guidelines, and medscape
For each of the scenarios below, answer the questions below using your required learning resources, clinical practice guidelines, and medscape. Explain the problem and explain how you would address the problem. When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications.?Use at least 3 sources for each scenario and cite sources using APA format.
Jamie is a 38-year-old homeless bipolar patient that presents with an acute psychotic episode. He tells you that he has been on lithium for years and was recently started on imipramine 75 mg daily by someone at a free clinic. What treatment plan would you develop for Jamie? How would you monitor therapy?
Treatment Plan for Jamie, a 38-year-old Homeless Bipolar Patient
1. Assessment and Evaluation: Conduct a comprehensive psychiatric evaluation to confirm the diagnosis of bipolar disorder and assess the severity of the current episode. This evaluation should include a thorough medical history, mental status examination, and assessment of any co-occurring conditions.
2. Hospitalization: Given Jamie\’s homelessness and acute psychotic episode, the first step would be to ensure his safety and stability. This may require hospitalization in a psychiatric facility where he can receive comprehensive care and monitoring.
3. Medication Management: Jamie is currently on lithium, which is a suitable choice for long-term management of bipolar disorder. However, the recent addition of amitriptyline (an tricyclic antidepressant) by the free clinic may not be ideal. Amitriptyline can exacerbate psychosis and mania in patients with bipolar disorder. Therefore, it would be advisable to discontinue amitriptyline.
4. Addition of Antipsychotic Medication: To manage Jamie\’s acute psychotic episode, an antipsychotic medication should be added to his treatment plan. Aripiprazole (Abilify) or olanzapine (Zyprexa) are suitable options. These medications can help reduce psychotic symptoms and are less likely to exacerbate manic symptoms compared to other antipsychotics.
5. Mood Stabilizer: Given Jamie\’s bipolar diagnosis, it\’s crucial to continue his lithium therapy. Lithium is a first-line treatment for bipolar disorder and can help manage both manic and depressive symptoms. Regular monitoring of lithium levels will be necessary to ensure efficacy and prevent toxicity.
6. Psychosocial Support: In addition to medication, psychosocial interventions are crucial for Jamie\’s recovery. This could include counseling, therapy, and social skills training. Given his homelessness, assistance in securing stable housing should also be a priority.
7. Continued Monitoring and Follow-up: Regular monitoring and follow-up appointments are essential to assess Jamie\’s response to treatment, adjust medications if necessary, and address any concerns or side effects. It is important to work collaboratively with a healthcare provider to ensure the treatment plan is tailored to Jamie’s specific needs.
Paper Format: APA
Number of pages: 2
3 sources
Answer preview to clinical practice guidelines, and medscape
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