Integumentary Function:K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.Case Study QuestionsName the most common triggers for psoriasis and explain the different clinical types.There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.Included in question 2A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?What others manifestation could present a patient with Psoriasis? post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources.

Describe three (3) dangers you believe embryonic stem cell research can present to society. Consider the medical or scientific arguments supporting the use of embryos to achieve health benefits. Finally, prepare a 1-paragraph statement opposing the research.

Choose a medication that is in the antipsychotic classification. This can be a first-generation or se The FDA indications for treatment The mechanism of action The side effects Dosage Pearls for treatment Side effects Special considerations Lab work to monitor Pregnancy/breastfeeding indication Elderly special considerations Renal and hepatic considerations, etc. Then find two research articles to support your medication with research, new findings, etc. The articles should be published within the last 3 years and peer-reviewed.cond-generation antipsychotic. responses #1 thersa c. Haloperidol 1. FDA Indications for Treatment: psychotic disorders, tics (i.e.- Tourette’s Syndrome), treatment of schizophrenic patients who require prolonged parenteral antipsychotic therapy, short-term therapy for hyperactive children 2. Mechanism of Action: blocks dopamine 2 receptors, reducing positive symptoms; and blocks dopamine 2 receptors in the nigrostriatal pathway 3. Side Effects: Neuroleptic-induced deficit syndrome, akathisia, dug-induced parkinsonism, tardive dyskinesia, tardive dystonia, galactorrhea, amenorrhea, dizziness, sedation, dry-mouth, constipation, blurred vision, urinary retention, decreased sweating, hypotension, tachycardia, hypertension, and weight gain. Rare or Life-Threatening Side Effects: neuroleptic malignant syndrome, rhabdomyolysis, seizures, jaundice, agranulocytosis, leukopenia, increased risk of death and cerebrovascular events in elderly patients with dementia 4. Dosage: 1-40mg by mouth daily; immediate release- 2-5mg per dose; Decanoate injection 10-20 times the previous day dose of oral antipsychotic; oral initial dosing- 1-15mg/day with a single dose or divided doses amongst the day. 5. Pearls for Treatment: Prior to the introduction of atypical antipsychotics, haloperidol was one of the most preferred antipsychotics; may still be a useful antipsychotic especially at low doses for those patients who require management with a conventional antipsychotic or who cannot afford an atypical antipsychotic; less-sedating than many other conventional options; Haloperidol is often used to treat delirium (generally in combination with lorazepam- Haloperidol being 2x’s greater than the Lorazepam’s). 7. Contraindications: if signs of neuroleptic malignant syndrome (NMS) treatment should be immediately discontinued; use with caution in patients with respiratory conditions; do not use with patients in a comatose state or has CNS depression / Parkinson’s / proven allergy to haloperidol 8. Lab Work / Items to Monitor: weight / BMI, CBC (especially if history of drug-induced leukopenia / thrombocytopenia, etc.), fasting triglycerides monthly for several months in patients with high risk for metabolic complications when initiating or switching antipsychotics. 9. Pregnancy/Breastfeeding Indication: controlled studies have not been conducted in pregnant women; risk of abnormal muscle movement with withdrawal symptoms in newborns whose mothers took an antipsychotic during the third trimester; reports of drug-induced parkinsonism, jaundice, hyperreflexia, hyporeflexia in infants whose mothers took a conventional antipsychotic during pregnancy; contraindicated during the first trimester. Breast feeding: some drug is found in breast mild—recommended to discontinue the drug or bottle feed. 10. Elderly Special Considerations: lower doses should be used, and patient should be monitored closely; no agents have been approved for treatment of elderly patients with behavioral symptoms of dementia such as agitation. 11. Renal and Hepatic considerations: Use with caution in both renal / hepatic impairment patients; cardiac patients have an increased risk of orthostatic hypotension and possible risk of prolonged QT / Torsades with IV administration; Children: safety and efficacy have not been established. In upcoming research, haloperidol has been evaluated among the inpatient population, in treatment of COVID-19. Currently, the limited data does not increase intubated death, nor increase ability to discharge home (Hoertel et al, 2021). More research will be needed to further investigate this topic. There is not much of a place for Haloperidol in the outpatient setting, as there is in the acute settings anymore. This is mostly because the newer antipsychotics have less side effects and able to be used more efficiently in long-term settings (Stahl, 2013). References Hoertel, N., Sánchez-Rico, M., Vernet, R., Jannot, A.-S., Neuraz, A., Blanco, C., Lemogne, C., Airagnes, G., Paris, N., Daniel, C., Gramfort, A., Lemaitre, G., Bernaux, M., Bellamine, A., Beeker, N., & Limosin, F. (2021). Observational study of haloperidol in hospitalized patients with COVID-19. PloS One, 16(2), e0247122. https://doi-org.libauth.purdueglobal.edu/10.1371/j... Stahl, S., Grady, M. M., & Muntner, N. (2021). Stahl's Essential Psychopharmacology: Prescriber's Guide (7th ed). Cambridge University Press. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press. #2 tiffa ja FDA indications and side effects Quetiapine (Seroquel) is a second-generation antipsychotic for adults and children who are at least 13 years old. The FDA indications for quetiapine are for the treatment of schizophrenia, bipolar disorder, major depression, and mixed mania. It is also used to treat behavioral disturbances in dementia, Parkinson’s, and posttraumatic stress disorder The mechanism of action for quetiapine is to improve the positive and negative symptoms of schizophrenia and major depression by acting on various neurotransmitters receptors, such as the serotonin and dopamine receptors. The common side effects of quetiapine may include constipation, drowsiness, upset stomach, tiredness, QTc prolongation, weight gain, blurred vision, or dry mouth. Dizziness or lightheadedness may also occur, especially during the initial treatment (Stahl, 2021). In rare cases, quetiapine can cause drug-induced interstitial lung disease. In a new study, in critically injured trauma patients, quetiapine exposure was associated with increased pulmonary complications (PC) risk. Patients administered quetiapine were more likely to develop PC and acquire PC earlier than those without quetiapine (Topcuo?lu & Erdo?an, 2020). Dosing Dosing quetiapine will vary for different patients. For instance, the usual dose range for schizophrenia and bipolar mania is 400 mg-800 mg in 1 or 2 doses. The usual dose range for bipolar depression is 300 mg once daily. Occasionally, patients may require 800 mg-1200 mg for psychosis or mania (Stahl, 2021). Special considerations When taking quetiapine, one should avoid excessive exercise, stay inside as much as possible and dress lightly in hot weather, stay out of the sun, and drink plenty of fluids. Quetiapine may cause dizziness, lightheadedness, and fainting therefore, sudden position changes like getting up too quickly from a lying position should be avoided (Medline Plus, 2021). Another special consideration is delayed-seizure associated with quetiapine overdoses. It is suggested that providers who are evaluating or managing patients following quetiapine overdose should consider the possibility that the patient may be at risk for seizures for 24 hours (or longer), even in the absence of other symptoms of acute toxicity (Chen et al., 2018). Lab work to monitor Quetiapine may cause changes in your blood glucose levels cholesterol levels and heart function. Therefore, monitoring kidneys, liver, cholesterol, and glucose levels is important. Blood pressure monitoring as well as an ECG maybe be necessary to check heart function (Medline Plus, 2021). Pregnancy and breastfeeding Quetiapine may increase the chance of gestational diabetes. Quetiapine use in pregnancy may also increase the baby’s chance of low birth weight. However, research has also shown that when depression and other psychiatric conditions are left untreated during pregnancy, there could be an increased chance for pregnancy complications, including low birth weight. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to antipsychotic drugs during the third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery. It is unknown if quetiapine is secreted in human breast milk, but all psychotropics are assumed to be secreted in breast milk. It is recommended to either discontinue the drug or bottle feed if possible. However, if a woman chooses to breastfeed while on quetiapine should be monitored for possible adverse effects (Stahl, 2021). Elderly and renal/hepatic considerations Quetiapine has a black box warning of potentially increasing the mortality of elderly patients with dementia-related psychosis. It may increase the risk of falls due to drowsiness, orthostatic hypotension, or motor or sensory instability. There are also other significant adverse effects on the cardiovascular system and metabolic syndrome (Medline Plus, 2021). There is no dose adjustment required for renal impairment. However, downward dose adjustment may be necessary for hepatic impairment (Stahl, 2021). References Chen, J. A., Unverferth, K. M., & Cheung, E. H. (2018). Delayed-Onset Seizure in a Mild Quetiapine Overdose: Report of a Case and Review of the Literature. Case Reports in Psychiatry, 1–3. Medline Plus. (2021, December 16). Quetiapine. National library of medicine. Retrieved December 22, 2021, from https://medlineplus.gov/druginfo/meds/a698019.html Stahl, S. M. (2021). Stahl's Essential Psychopharmacology: Prescriber's Guide (7th ed.). Cambridge University Press. Topcuo?lu, M., & Erdo?an, A. (2020). Interstitial Lung Disease due to Quetiapine: Case Report and Literature Review. Duzce Medical Journal, 22(2), 140–142.