Psychotic Disorder Treatment Paper Example

Introduction

The patient, a 34-year-old Pakistan, has been presented for a 21-day hospitalization since she is suffering from a psychotic disorder. Besides, she was perceived with Schizophrenia diagnosis since it is clear that her health condition has persisted for a month. Consequently, an appropriate decision ought to be made in her case to ensure correct treatment of the diagnosis. Notably, the client's condition attributes to being induced by an arranged marriage which had got organized since she was nine. Nevertheless, the patient's psychotic condition does not seem to have developed to advanced levels since she can recognize the place, event, time and she is alert.

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Additionally, she is also appropriately dressed. Contrastingly, the client shows some traits of mental impairment such as slow speech interrupted by prolonged periods of silence, euthymic mood and her judgment as well as insight gets compromised. In carrying out the client's treatment procedures, some decisions need to be made.

Decision 1

With three choices to make on how to begin the treatment, I choose to start the client with a dose of Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day four and monthly subsequently. Consequently, the decision got selected leaving two other possible choices of commencing the treatment. These two decisions were: to begin with Zyprexa 10mg orally at bedtime and the other to start Abilify 10 mg orally at night. Zyprexa 10 mg would not get selected for the start of the treatment due to its side effects.

Notably, some of the side effects are dizziness, weakness, and drowsiness. Additional problems that come as a result of Zyprexa 10 mg drug usage include constipation, stomach pain, and memory problem. Also, back pain and missed menstrual period among female clients are also side effects related to the use of the drug as mentioned above (Li et al. 2011). Henceforth this drug ought not to be the top choice for the client.

The other alternative that can get used to starting treatment which is the administration of Abilify 10 mg orally during bedtime is a poor start decision due to its history of nonconformity with oral antipsychotic. Notably, the reasons above justify why the alternatives get left out and starting Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly afterward was considered. This decision is regarded as the best for the client currently (Li et al. 2011). Notably, the drug acts through changing the effects of chemicals in the client's brain. Moreover, the drug boost client compliance with her treatment since it removes the necessity of taking oral doses.

There are anticipations that the client will report to the outpatient clinic after four weeks with a significant drop in indicators of Schizophrenia disorder such as delusional thoughts as well as auditory hallucinations. Notably, the anticipated medication outcome would be, and the client will have a drop in indicators. There is a reduction in PANSS score, and the patient can be tolerant of the drug. Also, the client's weight was reported to have increased in the areas of injection. Henceforth, this made the client uncomfortable to sit after injections.

Decision 2

The choice is to continue with the administration of Invega Sustenna 234 mg drug. In this case, the nurse should get instructed to administer the medication through injections into the deltoid muscle (Gao et al. 2011). The decision of persisting in usage of the Invega Sustenna was selected leaving two choices of stopping administration of Invega Sustenna 234 mg and start Haldol Decanoate 50 mg with Haldol 5 mg BID for the next three months and continuing with Invega Sustenna administration on addition of Abilify Mainteina 300g intramuscular monthly plus oral Abilify 10 mg in the morning for two weeks.

The reason for maintaining the choice of administering Invega Sustenna drug is to maintain consistency. Consequently, the result exhibited by continued use of Invega drug has an extra advantage over the other options. (Sliwa et al., 2011). Notably, the patients PANSS result reduced from twenty-five percent to fifty percent.

Similarly, the client expressed that getting injected in the arm is better compared to injection at the back which caused sitting discomfort. Due to prolonged usage of the Invega drug, the client has gained weight to new 2.5pounds. Also, it is clear that the patient is impressed by his feeling about the drug. According to her, Invega drug is better since it does not lead to much weight gain as other choices of medicine would do (Li et al. 2011).

Decision 3

The decision is whether to drop Invega drug and start Abilify Maintena 400 mg IM monthly, continue administering Invega Sustenna or proceed with Invega Sustenna administration and add Qsymia for weight loss. The plans for this decision is to keep injecting Invega Sustenna on the patient though it results in more weight gain (Gao et al. 2011). Notably, use of the drug has shown positive results. Consequently, the weight gain can get controlled through exercising and adjusting the patient's diet.

The choice of using Invega Sustenna and Qsymia does not apply well with the patient since there is fear of drug interaction with Invega which might result in toxicity (Sliwa et al. 2011). Abilify maintena is a better decision but may not be sufficient for this patient. Client's weight loss can get maintained through diet adjustment and regular exercise.

References

Gao, Y., Li, Z., Sun, M., Guo, C., Yu, A., Xi, Y., ... & Zhai, G. (2011). Preparation and Characterization of intravenously injectable curcumin nanosuspension. Drug delivery.

Li, H., Rui, Q., Ning, X., Xu, H., & Gu, N. (2011). A comparative study of paliperidone palmitate and risperidone long-acting injectable therapy in schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry.

Sliwa, J. K., Bossie, C. A., Ma, Y. W., & Alphs, L. (2011). Effects of acute paliperidone palmitate treatment in subjects with schizophrenia recently treated with oral risperidone. Schizophrenia research.