develop a pharmacology treatment Algorithm of a patient with a DSM diagnosis. You can use your readings to change and add to your work, but it must be an original and not a copy of an algorithm from someone else. This is an algorithm developed specifically for this client to demonstrate your critical thinking throughout the treatment planning. The following areas must be covered in the assignment.
Overview of your initial patient clinical assessment including: Chief compliant, medical history, psychiatric history, psychosocial, mental status examination.
Using the information from the assessment, reading materials and textbook, develop an evidence-based algorithm for four treatment stages, tailored to this individual. The information must include interview questions needed to guide decision-making at the different stages, length of treatment in trial/initiation period, dosage titration schedule and duration of time the client should stay on the medication, factors that might influence the effectiveness of the medications, necessary labs and test, and patient education. Include pertinent side effects profiles that would warrant a change in the medication being prescribed and a brief reasoning for your decisions.
Stage 1: initial visit
Stage 2: non-responder to stage 1
Stage 3: non-responder to stage 2
Stage 4: non-responder to stage 3
It must be in an APA format not less than 5 references.
The paper must have a graphic illustration of the psychopharmacologic medication algorithm.
This assignment must be 8-10 pages (excluding the title and reference page).
Stage I: Tessa is a 28 year computer sales agent who lose her job 3 months ago. She has been isolative at home and stopped socializing with friends and family since then. She recently started taking Paxil 20 mg PO once daily as prescribed for depression which she usually takes in the morning. Tessa reported that for the last couple of weeks she has not been sleeping (only 2-3 hours daily)and has so much energy. She has racing thoughts and has been engaging in extreme sports like bungee jumping and sky diving which is unusual for her. According to her sister, who was with her during the visit, Tessa has been hypertalkative for the past 3 weeks which is not like her. Per report, her mood disturbance is sufficiently severe that she is incapable of functioning normally in a social gathering. Her current condition is not attributable to the physiological effects of a substance or any other medical condition. Her sister thinks Tessa needs help before her condition worsens due to lack of sleep and engagement in thrill seeking adventures.
Stage II: week 1= Abilify 10 mg tablet by mouth every morning in addition to Ativan 1 mg tablet by mouth twice a day as needed.
Stage III: week 2= Abilify 15 mg tablet by mouth every morning plus Ativan 1 mg tablet by mouth twice a day as needed then add Depakote DR 500 mg tablet by mouth twice a day.
Stage III: week 3= Abilify 15 mg tablet by mouth every morning with Depakote DR 500 mg tablet by mouth twice a day plus Ativan 1 mg tablet by mouth 3 times a day as needed.
NOTE: Ativan will be stopped in week 4 when manic episode subsides and Abilify and Depakote DR deemed to be working.
* There will be monthly blood work for Depakote level to ensure depakote is within range and not in the near toxic level.
* Tessa will be educated on medication compliance for sudden stop in taking these medications may lead to hopelessnesss, helplessnessand even suicidal thoughts. Expect to gain weight which can be managed with making healthy lifestyle choices such as regular exercise and healthy diet. Suicidal thoughts or behavior is possible the first few months of treatment.
* Report any paradoxical effect such as agitation, vertigo or lightheadedness, sexual dysfunction or increased salivation.
* Report to the doctor immediately presence of uncontrollable and excessive urges and behavior, tachycardia, high or low blood pressure, difficulty breathing, convulsions, increased sweating, loss of bladder control, severe muscle stiffness and unusually pale skin or tiredness.
