Bipolar-1-Disorder Therapy Essay Paper

Bipolar-1-Disorder Therapy Essay Paper

Assignment: Assessing and Treating Clients with With Bipolar Disorder
Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) Bipolar-1-Disorder Therapy Essay Paper.many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.
Learning Objectives
Students will:
• Assess client factors and history to develop personalized plans of bipolar therapy for clients
• Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy
• Evaluate efficacy of treatment plans
• Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan

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To prepare for this Assignment:
• Review this week’s Learning Resources. Bipolar-1-Disorder Therapy Essay Paper.Consider how to assess and treat clients requiring bipolar therapy.
The Assignment
Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
• Decision #1
o Which decision did you select?
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Bipolar-1-Disorder Therapy Essay Paper.Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
• Decision #2
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
• Decision #3
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Bipolar-1-Disorder Therapy Essay Paper.Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.Bipolar-1-Disorder Therapy Essay Paper
NOTE
SEE ATTACHED FOR THE DECISIONS OPTIONS 1, 2 OR 3. READ AND SEE WHICH OPTION IS BEST FOR YOU. I THINK THE BEST ONE IS OPTION-1

ALL RREFERENCES 5 YEARS OR LESS. TRY TO INCLUDE THE TEXT BOOK FROM STAHL WHICH YOU ARE READING FROM. Bipolar-1-Disorder Therapy Essay Paper
THE ACCESS TO STAHL BOOK ONLINE IS AS FOLLOWS:
www.stahlonline.org
USER NAME: owusuk784
PASSWORD: michael3910

PROVIDE INTRODUCTION BRIEF, PURPOSE AND CONCLUSION

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.Bipolar-1-Disorder Therapy Essay Paper

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

 

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.Bipolar-1-Disorder Therapy Essay Paper

 

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

  • Chapter 6, “Mood Disorders”
  • Chapter 8, “Mood Stabilizers”

Stahl, S. M., & Ball, S. (2009b). Stahl’s illustrated mood stabilizers. New York, NY: Cambridge University Press.

 

To access the following chapters, click on the Illustrated Guides tab and then the Mood Stabilizers tab.

  • Chapter 4, “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar Disorder”
  • Chapter 5, “Atypical Antipsychotics as Mood Stabilizers for Bipolar Disorder”

Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-0060-3

Note: Retrieved from Walden Library databases.

Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects:Bipolar-1-Disorder Therapy Essay Paper. comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6

Note: Retrieved from Walden Library databases.

Required Media

Laureate Education. (2016f). Case study: An Asian American woman with bipolar disorder [Interactive media file]. Baltimore, MD: Author

 

Note: This case study will serve as the foundation for this week’s Assignment.

 

Optional Resources

Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial. Acta Medica Iranica, 52(10), 734-739.
Retrieved from http://acta.tums.ac.ir/index.php/acta

Bipolar Therapy
Client of Korean Descent/Ancestry

 

Decision Point One

Begin Risperdal 1 mg orally BID

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Client is accompanied today by her mother who must help the client into your office, the client looks very sedated and lethargic
  • Client's mother explains that “she has been like this since about a week after the last office visit”Bipolar-1-Disorder Therapy Essay Paper

Decision Point Two

 

Decrease Risperdal to 1 mg at HS

 

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Client is less sedate, less lethargic and shows symptom improvement
  • Young Mania Rating Scale has decreased from 22 to 16 (a bit more than a 25% decrease in symptoms)Bipolar-1-Disorder Therapy Essay Paper

Decision Point Three

 

Continue at same dose of Risperdal and reassess in 4 weeks

 

Guidance to Student
At this point, the PMHNP may be wise to allow the client to remain at the same dose and reassess in 4 weeks. Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may have slower clearance of Risperdal from her system, which may have resulted in higher than normal levels of Risperdal in the blood, which in turn resulted in sedation. Bipolar-1-Disorder Therapy Essay Paper.Therefore, if we were to increase back to 1 mg orally BID, she may have the same side effects. Latuda is FDA approved for bipolar I depression, which is not the presentation we are attempting to treat. Additionally, it is quite expensive and many insurance companies will not pay for it until other agents have been attempted and failed.Bipolar-1-Disorder Therapy Essay Paper

Bipolar Therapy
Client of Korean Descent/Ancestry

 

Decision Point One

 

Begin Seroquel XR 100 mg orally at HS

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Client is reporting that she sleeps a bit more at bedtime
  • Client states that she has gained about 2 or 3 pounds, which she does not like
  • Client also reports that she has been constipated since starting this medication
  • Client is also complaining of dry mouth which she does not like.Bipolar-1-Disorder Therapy Essay Paper
  • Client's score on the Young Mania Rating Scale has decreased from a 22 to an 18
  • Client is reporting really good mood, but is asking for a different medication because of the weight gain

 

 

Decision Point Two

 

Discontinue Seroquel and start Geodon 40 mg orally BID. Administer with 500 calorie meal

 

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Client demonstrates a 50% decrease in score on the Young Mania Rating Scale (from 22 to 11)Bipolar-1-Disorder Therapy Essay Paper
  • Client denies any additional weight gain and denies any additional side effects

 

Decision Point Three

 

Continue same dose and reassess in 4 weeks

 

Guidance to Student
The PMHNP should provide counseling to the client about this side effect and encourage increased fluids and fiber in the diet to combat constipation. Bipolar-1-Disorder Therapy Essay Paper.Hard candies or gum can be used to prevent dry mouth. This is another issue as the drug can cause dental problems as a result of dry mouth.

Changing to Geodon clearly helped with symptoms and arrested weight gain in this client.Bipolar-1-Disorder Therapy Essay Paper. The PMHNP could wait 4 weeks and see if any changes in Young Mania Rating Scale are noted, or increasing to 60 mg orally BID in an attempt to hasten symptom improvement. Increasing dose may be associated with side effects.

Augmentation with Lithium may be appropriate if the goal of therapy is to discontinue antipsychotic therapy and treat with Lithium monotherapy. Bipolar-1-Disorder Therapy Essay Paper.Lithium was problematic for this client but changing formulation to the extended release may overcome the difficulties she was experiencing with side effects. The PMHNP would need to educate client regarding side effects of medication and need to maintain compliance.Bipolar-1-Disorder Therapy Essay Paper