Therapy for Patients With Bipolar Disorders<\/p>\n
Marcus, an 18-year-old high school senior, presents with symptoms of difficulty sleeping and feeling sad, which result in an initial diagnosis of depression. His mother later reports, however, that Marcus exhibits symptoms of irritability and risk-taking behaviors. (His little brother reported to his mother that they were driving over 90 miles an hour on the highway.) After further Assessment, Marcus\u2019 psychiatric nurse practitioner diagnoses him with bipolar disorder.<\/p>\n
Cases like this are not uncommon with bipolar disorder, as initial assessments rarely provide all the information needed. In your role, as a psychiatric nurse practitioner, you must develop strategies for properly assessing and diagnosing these patients because treatments for bipolar disorder are significantly different than treatments for depression or other mood disorders.<\/p>\n
This week, as you examine bipolar therapies, you explore the assessment and treatment of patients with bipolar disorder. You also consider ethical and legal implications of these therapies.<\/p>\n
Learning Objectives<\/p>\n
Students will:<\/p>\n
\u00b7 Assess patient factors and history to develop personalized plans of bipolar therapy for patients<\/p>\n
\u00b7 Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring bipolar therapy<\/p>\n
\u00b7 Synthesize knowledge of providing care to patients presenting for bipolar therapy<\/p>\n
\u00b7 Analyze ethical and legal implications related to prescribing bipolar therapy to patients across the life span<\/p>\n
Learning Resources<\/p>\n
Ostacher, M. J., & Hsin, H. (2016). The use of antiepileptic drugs in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 93\u201398). Elsevier.<\/p>\n
Perlis, R. H., & Ostacher, M. J. (2016a). Bipolar disorder. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 48\u201360). Elsevier.<\/p>\n
Perlis, R. H., & Ostacher, M. J. (2016b). Lithium and its role in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 86\u201392). Elsevier.<\/p>\n
Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20\u201326). Elsevier.<\/p>\n
American Psychiatric Association. (2010b). Practice guideline for the treatment of patients with bipolar disorder (2nd ed.). https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/bipolar.pdf<\/p>\n
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\u2013841. https:\/\/doi.org\/10.1007\/s00228-015-1855-6<\/p>\n
Hirschfeld, R. M. A. (n.d.). Guideline watch: Practice guideline for the treatment of patients with bipolar disorder (2nd ed.). https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/bipolar-watch.pdf<\/p>\n
Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic\/mixed bipolar disorder? CNS Drugs, 27(5), 331\u2013333. https:\/\/doi.org\/10.1007\/s40263-013-0060-3<\/p>\n
Medication Resources (click to expand\/reduce)<\/p>\n
https:\/\/www.micromedexsolutions.com\/micromedex2\/librarian\/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537<\/p>\n
Review the following medications:<\/p>\n
\u00b7 amitriptyline<\/p>\n
\u00b7 bupropion<\/p>\n
\u00b7 citalopram<\/p>\n
\u00b7 clomipramine<\/p>\n
\u00b7 desipramine<\/p>\n
\u00b7 desvenlafaxine<\/p>\n
\u00b7 doxepin<\/p>\n
\u00b7 duloxetine<\/p>\n
\u00b7 escitalopram<\/p>\n
\u00b7 fluoxetine<\/p>\n
\u00b7 fluvoxamine<\/p>\n
\u00b7 imipramine<\/p>\n
\u00b7 ketamine<\/p>\n
\u00b7 mirtazapine<\/p>\n
\u00b7 nortriptyline<\/p>\n
\u00b7 paroxetine<\/p>\n
\u00b7 selegiline<\/p>\n
\u00b7 sertraline<\/p>\n
\u00b7 trazodone<\/p>\n
\u00b7 venlafaxine<\/p>\n
\u00b7 vilazodone<\/p>\n
\u00b7 vortioxetine<\/p>\n
Required Media (click to expand\/reduce)<\/p>\n
https:\/\/cdnfiles.laureate.net\/2dett4d\/Walden\/NURS\/6521\/05\/mm\/decision_trees\/week_04\/index.html<\/p>\n
Optional Resources (click to expand\/reduce)<\/p>\n
http:\/\/acta.tums.ac.ir\/index.php\/acta<\/p>\n
Assignment: Assessing and Treating Patients With Bipolar Disorder
\nBipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients often present as depressive or manic but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder\u2019s pathophysiology. For this Assignment, as you examine the patient case study in this week\u2019s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder.<\/p>\n
To prepare for this Assignment:
\n\u00b7 Review this week\u2019s Learning Resources, including the Medication Resources indicated for this week.<\/p>\n
\u00b7 Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy.<\/p>\n
The Assignment: 5 pages
\nExamine Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient\u2019s pharmacokinetic and pharmacodynamic processes.<\/p>\n
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.<\/p>\n
Introduction to the case (1 page)<\/p>\n
\u00b7 Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.<\/p>\n
Decision #1 (1 page)<\/p>\n
\u00b7 Which decision did you select?<\/p>\n
\u00b7 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/p>\n
\u00b7 Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/p>\n
\u00b7 What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).<\/p>\n
\u00b7 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/p>\n
Decision #2 (1 page)<\/p>\n
\u00b7 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/p>\n
\u00b7 Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/p>\n
\u00b7 What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).<\/p>\n
\u00b7 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/p>\n
Decision #3 (1 page)<\/p>\n
\u00b7 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/p>\n
\u00b7 Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/p>\n
\u00b7 What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).<\/p>\n
\u00b7 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/p>\n
Conclusion (1 page)<\/p>\n
\u00b7 Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/p>\n","protected":false},"excerpt":{"rendered":"
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