Case Study Background:
This is a 42 year old single white male with a diagnosis of schizophrenia. His current symptoms include auditory hallucinations, disorganized speech, and diminished emotional expression. His father brings him in for psychiatric evaluation. The father reports that the patient stopped taking his Seroquel 400 mg BID for psychosis and melatonin 6 mg for sleep. He also reports that the patient is responding to external stimuli, talking to himself, not sleeping, and believes the government has bugged their home. This is the 3rd psychiatric admission in 2 years.
VS: BP 148/72, HR 88, Pulse oximetry 98%
HT 6\’1\” WT 230 lbs.
Appearance: Unkempt, poor hygiene, dressed in several layers of clothing (current season is late spring with avg temp 70 degrees outdoors).
Labwork: A1C 6.2%, Cholesterol 188, HDL 22, LDL 176, Triglycerides 148
Questions for case study:
- 1) Based on the case study information, what recommendations for medications would you make? Name the typical or atypical antipsychotic you would prescribe, and identify dose and administration.
- 2) Decide whether you would add any other medication? If so, identify which medication, dose, and time of administration.
- Please use an evidence based article, research article or textbook reference to support your decision for #1, #2.
- 3) Based on the chosen medications, what education would be provided?
- 4)Identify any lab tests you would order and explain rationale?
- 5) Would you refer this patient to any other provider(s)? If so, to whom would you refer? Provide rationale for referral.
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