PMH/502: Neuropsychiatric Pharmacology/ Summative Assessment: Pharmacological Treatment Case Study

Summative Assessment: Pharmacological Treatment Case Study

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As a psychiatric mental health nurse practitioner, you will be making choices about the treatment modalities you will use on each client. Despite your best efforts, there is no guarantee that your chosen treatment plan will work. Unfortunately, psychiatry often takes 2 to 3 treatment trials before a positive response is appreciated. The important thing is to be sure each client understands that failure of one medication does not mean failure of all possible medications and that you will continue to work with them to find the best treatment for them.

Read the case study provided here that you have also reviewed in the course PMH/501: Patient Case: Focus on Diagnostics.

Review the DSM-5 diagnoses and ICD-10 codes associated with the case study.

Identify psychiatric diagnoses in the case study.

Patient L.M. returns to you today. From a review of his medical record, you find that he was starting on carbamazepine 5 weeks ago and has been titrated up to 600 mg po BID with a steady-state blood concentration at that level of 10 mcg/mL for 4 weeks. He is quite angry with you and says: “I am no better now than the first day I saw you.” His MSE remains the same as the first visit, but he does admit that he doesn’t feel any worse. He claims the suicidal thoughts are about the same but that he has developed a safety plan to contact his lawyer if they worsen. All aspects of his original plan of care have been handled. On reviewing his labs, you find that two weeks ago, his creatinine values improved, and his CrCl at that time was 95 mL/min. You also observe that this agrees with the labs you had him do yesterday.

Write a patient treatment plan (750 to 1,000 words):
Describe what you think is going on and what actions you would take. Be sure to include drug names, doses, titration plans, and additional laboratory tests you would order and how often you would order them.
Include in your plan any new educational information L.M. will need and your follow-up plan.

Refer to your course textbooks, especially Stahl’s Essential Psychopharmacology: Prescriber’s Guide.

Use and cite 2 additional sources in UpToDate or the University Library to support your treatment plan.

Format your sources using APA style.

Stahl, S. M. (2021). <i>Stahl’s essential psychopharmacology</i> (5th ed.). Cambridge University Press.
Read Ch. 4, “Psychosis, Schizophrenia, and the Neurotransmitter Networks Dopamine, Serotonin, and Glutamate.”

Read Ch. 5, ‘Targeting Dopamine and Serotonin Receptors for Psychosis, Mood, and beyond: So-Called “Antipsychotics.” ‘
Psychiatric-Mental Health Nurse Practitioner, Ch. 11

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