course material

1. Treating Patients With Bipolar Disorder.
Treating Patients With Bipolar Disorder.Treating Patients With Bipolar
Disorder.Assignment: Assessing and Treating Patients With Bipolar DisorderBipolar
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’s pathophysiology.
For this Assignment, as you examine the patient case study in this week’s Learning
Resources, consider how you might assess and treat patients presenting with bipolar
disorder.To prepare for this Assignment:Review this week’s Learning Resources, including
the Medication Resources indicated for this week.Reflect on the psychopharmacologic
treatments you might recommend for the assessment and treatment of patients requiring
bipolar therapy. The Assignment: 5 pagesExamine 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’s pharmacokinetic and pharmacodynamic processes. BACKGROUND
INFORMATIONThe client is a 26-year-old woman of Korean descent who presents to her
first appointment following a 21-day hospitalization for onset of acute mania. She was
diagnosed with bipolar I disorder. Upon arrival in your office, she is quite “busy,” playing
with things on your desk and shifting from side to side in her chair. She informs you that
“they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing.
Did I tell you that I liked to cook?” She weights 110 lbs. and is 5’ 5”ORDER NOW FOR
CUSTOMIZED, PLAGIARISM-FREE PAPERS SUBJECTIVEPatient reports “fantastic” mood.
Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.”You
reviewed her hospital records and find that she has been medically worked up by a
physician who reported her to be in overall good health. Lab studies were all within normal
limits. You find that the patient had genetic testing in the hospital (specifically GeneSight
testing) as none of the medications that they were treating her with seemed to work.
Genetic testing reveals that she is positive for CYP2D6*10 allele. Patient confesses that she
stopped taking her lithium (which was prescribed in the hospital) since she was discharged
two weeks ago. MENTAL STATUS EXAMThe patient is alert, oriented to person, place, time,
and event. She is dressed quite oddly- wearing what appears to be an evening gown to her
appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect

2. broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid
thought processes readily apparent. Judgment is grossly intact, but insight is clearly
impaired. She is currently denying suicidal or homicidal ideation.The Young Mania Rating
Scale (YMRS) score is 22 RESOURCES§ 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), 835-841.
doi:10.1007/s00228-015-1855-6Decision Point OneSelect what you should do:Begin
Lithium 300 mg orally BIDBegin Risperdal 1 mg orally BIDBegin Seroquel XR 100 mg orally
at HSAt 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. Introduction to the case (1
page)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. Decision #1 (1 page)Which decision did you select?Why did you select this
decision? Be specific and support your response with clinically relevant and patient-specific
resources, including the primary literature.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.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).Explain how ethical
considerations may impact your treatment plan and communication with patients. Be
specific and provide examples. Decision #2 (1 page)Why did you select this decision? Be
specific and support your response with clinically relevant and patient-specific resources,
including the primary literature.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.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).Explain how ethical considerations may impact
your treatment plan and communication with patients. Be specific and provide
examples. Decision #3 (1 page)Why did you select this decision? Be specific and support
your response with clinically relevant and patient-specific resources, including the primary
literature.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.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).Explain how ethical considerations may impact your treatment plan and
communication with patients. Be specific and provide examples. Conclusion (1
page)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.