what is the best treatment of bipolar in Asian women?

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User Generated

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Glsh

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Health Medical

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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
- Which decision did you select?
- Why did you select this decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
- Why did you select this decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
- Why did you select this decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
- 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.

Unformatted Attachment Preview

BACKGROUND INFORMATION The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?” She weights 110 lbs. and is 5’ 5” SUBJECTIVE Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.” You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. Genetic testing reveals that she is positive for CYP2D6*10 allele. Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago. MENTAL STATUS EXAM The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation. The Young Mania Rating Scale (YMRS) score is 22 RESOURCES § 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: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6
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Explanation & Answer

Attached.

Running Head: TREATMENT OF BIPOLAR I DISORDER

Treatment of Bipolar I Disorder
Name
Institution Affiliation
Date

1

TREATMENT OF BIPOLAR I DISORDER

2

Treatment of Bipolar I Disorder
The characteristic of Bipolar I disorder is primarily a disruption in the mood. Bipolar I
disorder is the leading cause of worldwide disability, which affects 1-1.5% of the entire
population of the United States. The condition presents with alternation phases of depression and
mania, abnormal circadian rhythms, cognitive dysfunction and comorbid general medical and
psychiatric conditions (Wittkowski, McGrath and Peters, 2014). As a consequence, bipolar
disorder may bring about a severe impact on individual functioning to the extent of affecting the
development of children when women are affected. Bipolar disorder has been found to be more
common in women who are compounded by the many roles that women play such as being
wives, caregivers of the elderly, mothers as well as having more risk factors for psychosis-like
abuse.
The patient in question is a 26-year-old Korean woman who was recently diagnosed with
Bipolar I disorder after she was admitted for 21 days with mania that was of acute onset. She was
treated and discharged on Lithium, which she did not comply with upon discharge. She is known
to be positive for the CYP2D6'10 allele. The patient is alert, oriented to time, place, person and
events. Her dressing is odd, and her speech is pressured, rapid and tangential. Her mood is
euthymic as she reports and effect is broad. Patient reports no auditory or visual hallucinations;
she has no paranoid or overt delusional thought processes that are readily apparent. She reports
about having a "fantastic" mood and problems with sleep. Her judgment is intact grossly, bu...