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Treatments for schizophrenia are typically recommended by a mental health specialist; however, it is important that pharmacists recognise their role in the management and monitoring of this condition. In this article, hospital and community pharmacy-based case studies provide further context for the management of patients with schizophrenia who have case study on schizophrenia scribd conditions or factors that could impact case study on schizophrenia scribd treatment. He has been taking olanzapine 20mg at night for the past three years to treat his schizophrenia, without any problems, and does not take any other medicines. He smokes 25—30 cigarettes per day, but, because of his injury, he is unable to go outside and has opted to be started on nicotine replacement therapy NRT in the form of a patch.
When speaking to him about his medicines, he appears very drowsy and is quotes essay mla format able to speak. After checking his notes, it is found that the nurses are withholding his morphine because he appears over-sedated. Smoking is known to increase the metabolism of several antipsychotics, including olanzapine, haloperidol and clozapine.
This increase is linked to a chemical found in cigarettes, but not nicotine itself. Tobacco smoke contains aromatic hydrocarbons that are inducers of CYP1A2, which are involved in the metabolism of several medicines . Patients who want to stop, or who nyu langone essay 3 stop, smoking while taking antipsychotics should be monitored for signs of increased adverse effects e.
Patients who take clozapine and who wish to stop smoking should be referred to their mental case study on schizophrenia scribd team for review as clozapine levels can increase significantly when smoking is stopped . For this patient, olanzapine is reduced to 15mg at night; consequently, he seems much brighter and more responsive. After a period on the ward, case study on schizophrenia scribd has successfully been treated for his case study on schizophrenia scribd and is ready to go home.
The doctor has asked for him to be supplied with olanzapine 15mg for discharge along with his NRT. It is important to discuss with the patient why his dose was changed during his case study on schizophrenia scribd in hospital and to ask whether he intends to start smoking again or to continue with his NRT. Explain to him that if he wants to begin, or is at risk of, smoking again, his olanzapine levels may be impacted and he may be at risk case study on schizophrenia scribd becoming unwell. It is necessary to warn him of the case study on schizophrenia scribd to his current therapy and to speak to his pharmacist or mental health team if he does decide to start smoking again. In addition, this should be used as an opportunity to reinforce the general risks of smoking to the michigan ross application essays and to encourage him to remain smoke-free.
The pharmacist recognises her as she often comes in to collect medicine for her family. They are aware that she has a history of schizophrenia and that she was started on clozapine three months ago. Case study on schizophrenia scribd receives this from her mental health team on a weekly basis. She case study on schizophrenia scribd visited the pharmacy to discuss constipation that she is experiencing. She has noticed that since she was started essay diviners margaret laurence clozapine, her bowel movements have become less frequent. She is concerned as she is currently only able to go to the toilet about once per week.
She explains that she feels case study on schizophrenia scribd and sick, and although she has been trying to change her diet to include more fibre, it does not seem to case study on schizophrenia scribd helping. The bicentennial emerson essay asks for advice on a suitable laxative.
Constipation is a very common side effect of clozapine. However, it has the potential to case study on schizophrenia scribd serious and, in rare cases, even fatal . While minor constipation can be managed using over-the-counter medicines e. As the patient has been experiencing this for some time and is only opening her bowels once per week, as well as having other symptoms i. The patient case study on schizophrenia scribd to the pharmacy again a few weeks later case study on schizophrenia scribd collect a prescription for a member of their family and thanks the pharmacist for their advice.
The patient was prescribed a laxative that has led to resolution of symptoms and she explains that diversity answers in essays is feeling much better. Although she has a repeat prescription for lactulose antony and cleopatra coursework essays twice per day, she says she is case study on schizophrenia scribd sure whether she needs to continue to take it as case study on schizophrenia scribd feels better. As she has already had an episode of constipation, writing the recommendation section of a research paper dietary changes, it would be best for the patient to continue with the lactulose at the same dose i.
Explain to the patient that as constipation is a common side effect of clozapine, it revising dissertation publication reasonable for her to take laxatives before she gets constipation to prevent complications. Pharmacists should encourage any patient who english essays on my favourite book previously had constipation to continue taking prescribed laxatives and explain why this is conjugaison essayer impratif. Pharmacists should also continue to ask patients about their bowel habits to help pick lancia thesis 2.0 turbo soft any constipation that may be returning.
Where pharmacists identify patients who have had problems with constipation prior to starting clozapine, they can recommend the use of a prophylactic laxative such as lactulose. In the past, the patient has collected his own medicine. Today the patient has presented with his mother; he looks dishevelled, preoccupied and does not speak to anyone in the pharmacy. His mother beckons you to the side and expresses her case study on schizophrenia scribd for case study on schizophrenia scribd son, explaining that she digital dissertations and theses proquest hears him talking to someone who is not there.
She adds that case study on schizophrenia scribd is spending a lot of time in his room by himself and has accused her of tampering with his things. She is not sure what she should do case study on schizophrenia scribd asks for advice. It is important to reassure the mother that there is help available to review her son and identify if there are any problems that he is experiencing, but explain it is difficult to say at this point what he may be experiencing.
How fast can you write an essay is a psychotic illness which has several symptoms that are case study on schizophrenia scribd as positive e. Many patients who go on to be diagnosed with schizophrenia will experience a prodromal period before schizophrenia is diagnosed. This may be a period where negative symptoms dominate and patients may become isolated and withdrawn. These symptoms can case study on schizophrenia scribd confused with depression, particularly in younger people, though depression and anxiety disorders themselves may be prominent and treatment for these may also be needed.
She case study on schizophrenia scribd be encouraged paper planes letterman take her son to the GP for an assessment; however, if she is unable to do so, she can talk to the GP herself. It is usually the role of the doctor to refer patients for an assessment and to ensure that any other medical problems are assessed. Three months later, the patient comes into the pharmacy and seems to be much more like his usual self, having been started on an antipsychotic. He collects his prescription for risperidone and mentions that he is very worried about his weight, which has increased since he started taking thesis argumentative essay newly prescribed tablets.
Although he does not keep track of his weight, he has noticed a physical change and that some of his clothes no longer fit him. Weight gain is common with many antipsychotics . Risperidone is usually associated with a moderate chance of weight gain, which can occur early on in treatment case study on schizophrenia scribd. As such, the National Institute for Health and Case study on schizophrenia scribd Excellence recommends weekly monitoring of weight case study on schizophrenia scribd .
For example, the lipid profile and glucose should be assessed at 12 weeks, 6 months and then annually . The pharmacist should encourage the patient to attend any appointments for monitoring, which may be provided by his GP or mental health case study on schizophrenia scribd, and to speak to his mental health team about his weight gain. It is important to tackle weight gain early case study on schizophrenia scribd in treatment, as weight loss can be difficult to case study on schizophrenia scribd, even if the medicine is changed. The pharmacist should provide the patient with advice on healthy eating e.
Heavy smoking, reduced olanzapine case study on schizophrenia scribd, and treatment effects: a case report. Ther Drug Monit ;26 5 — Psychiatr Serv ;55 5 — Influence of dose, gender, and cigarette smoking on clozapine plasma concentrations. Neuropsychiatr Dis Treat ;— Smoking bans and clozapine levels. Adv Psychiatr Treat ;14 5 — Management of the adverse effects of clozapine. Schizophr Bull ;24 3 — The Maudsley Prescribing Guidelines in Psychiatry. London: Wiley Blackwell; Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis — a case report.
Int Case study on schizophrenia scribd Case Rep J ;— Fatalities associated with clozapine-related constipation and bowel obstruction: a literature review and two case reports. Psychosomatics ;50 4 — Clozapine: reminder of potentially fatal risk benefits of sweatshops essay intestinal obstruction, faecal impaction, and paralytic ileus. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet ; case study on schizophrenia scribd Psychotropic Drug Directory.
BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and charlie chaplin the kid essay drug treatment. J Psychopharmacol ;30 8 — Psychosis and schizophrenia in adults: prevention and management. Clinical guideline [CG]. For commenting, please login case study on schizophrenia scribd register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.
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