Case Study For Psychosis And Schizophrenia Assignment

Assignment: Study Guide for Medication Treatment Schizophrenia Spectrum and Other Psychosis Disorders
Psychosis and schizophrenia greatly impact the brain ’s normal processes, which interfere with the ability to think clearly. When symptoms of these disorders are uncontrolled, patients may struggle to function in daily life. However, patients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, you will develop a study guide for an assigned psychotropic agent for treating patients with Schizophrenia Spectrum and Other Psychotic Disorders. You will share your study guide with your colleagues. In sum, these study guides will be a powerful tool in preparing for your course and PMHNP certification exam Case Study For Psychosis And Schizophrenia Assignment.

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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 treatment of patients with Schizophrenia Spectrum and Other Psychotic Disorders.
Research your assigned psychotropic medication agent using the Walden Library. Then, develop an organizational scheme for the important information about the medication.
Review Learning Resource: Utah State University. (n.d.). Creating study guides. https://www.usu.edu/academic-support/test/creating_study_guides
The Assignment
Create a study guide for your assigned psychotropic medication agents. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the FDA-approved and Evidenced-Based, Clinical Practice Guidelines Research but also supported by at least three other scholarly resources Case Study For Psychosis And Schizophrenia Assignment.

Areas of importance you should address, but are not limited to, are:

Title page
Description of the Psychopharmacological medication agent including brand and generic names and appropriate FDA indication uses
Any supporting, valid and reliable research for non-FDA uses
Drug classification
The medication mechanism of action
The medication pharmacokinetics
The medication pharmacodynamics
Mechanism of Action
Appropriate dosing, administration route, and any considerations for dosing alterations
Considerations of use and dosing in specific specialty populations to consider children, adolescents, elderly, pregnancy, suicidal behaviours, etc.
Definition of Half-life, why half-life is important, and the half-life for your assigned medication
Side effects/adverse reaction potentials
Contraindications for use including significant drug to drug interactions
Overdose Considerations
Diagnostics and labs monitoring
Comorbidities considerations
Legal and ethical considerations
Pertinent patient education considerations
Reference Page

NB: Medication for this paper is ” OLANZAPINE”

Study Guide for Medication Treatment Schizophrenia Spectrum and Other Psychosis Disorders
1. What is the psychotropic medication used to treat schizophrenia and other psychosis disorders? Olanzapin (Monahan et al., 2022)Case Study For Psychosis And Schizophrenia Assignment.
a) What are the brand and generic names of the medication?
Brand name- Zyprexa, Zyprexa Zydis
Generic name- Olanzapine
Who are the appropriate FDA indication users? Adults and teenagers aged 13 years and above to treat Schizophrenia and bipolar disorder. Also approved for treatment in patients with depression episodes related with treatment-resistant depression and bipolar disorder type 1. In the latter, the medication is used with fluoxetine.
2. What supporting, valid and reliable research exists for non-FDA uses for olanzapine?
A double-blind, placebo study showed that the drug has a short-term efficacy in treating schizophrenia in adolescents and bipolar illness- Case reports suggest that the drug may be effective in treating anorexia and eating disorders-Research also shows that the drugs could be used to during chemotherapy and in treating acute agitation, anorexia nervos and delirium (Grover & Avasthi, 2019)Case Study For Psychosis And Schizophrenia Assignment.

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3. What is the drug classification of olanzapine?
Second-generation antipsychotic medication.
4. What is the mechanism of action of olanzapine?
Primarily acts on serotonin and dopamine receptors-works as an antagonist on dopamine D2 receptors present in mesolimbic pathway-blocks potential action of dopamine at the post-synaptic receptor (Thomas & Saadabadi, 2018). Establishes a loose bond with the receptor-hence dissociates easily. Enables normal dopamine neurotransmission.

Fig1 : Mechanism of action of olanzapine
5. What is the pharmacokinetics and pharmacodynamics of the medication?
Pharmacodynamics
Medication half-life-21 to 54 hours-Steady-state concentration achieved in a week following daily administration of the medication-has linear pharmacokinetics-volume of administration is 1000 liters-wide distribution of medication in the body-93% of medication binds to plasma proteins, alpha-1 acid glycoprotein and albumin –Highly metabolized in the liver (García et al., 2019)Case Study For Psychosis And Schizophrenia Assignment.

Fig 2: Plasma concentration of olanzapine.
Pharmacodynamics
Medication binds with serotonin, adrenergic α1, dopamine and histamine H1 receptors-has moderate affinity for serotonin and muscarinic (Reboucas et al., 2022). Binds weakly to β-adrenergic receptors, GABAA, and BZD.

Fig 3: Pharmacodynamics of olanzapine
6) What is the appropriate dosing, administration route, and any considerations for dosing alterations?
Administration routes-multiple routes of administration-orally, intramuscular injection.
The tablet form comes in 2.5 mg, 7.5 mg, 2.5 mg, 5 mg, 15 mg, 20 mg and 10 mg dosages for adults. Also available in injectable form at 5mg/Ml dosage-available as orally disintegrating tablets at 5, 10, 15 and 20 mg dosages; Intramuscular injection-10mg.
Dosing considerations
Dosage adjustments should be done within 24 hour intervals. For adults with Bipolar-Related Agitation and Schizophrenia in adults, they should be given 10 mg IM and 5-7.5 mg for geriatric patients; administer 10mg IM in subsequent dose 2 hours after the initial dose and 4hours afterwards. Dosage should not exceed 30mg per day Case Study For Psychosis And Schizophrenia Assignment.
7) What is the considerations of use and dosing in specific specialty populations to consider children, adolescents, elderly, pregnancy, suicidal behaviours, etc
For adults with schizophrenia, taken 5-10mg daily through oral means; medication also taken through intramuscular means, extended-release.
For children and adolescents with schizophrenia (13-17 years)-2.5-5mg/ daily-taken orally. Target is a maximum of 10mg per day; increments of 2.5mg-5mg.
8) What is the definition of Half-life, why half-life is important, and the half-life for your assigned medication?
Half-life-time taken for a drug’s active substance to reduce by half in the body; importance-determines steady-state concentrations and excretion rates of drugs; Half-life of olanzapine-21-54 hours.
9) What is the side effects/adverse reaction potentials of olanzapine?
Increases risk of tardive dyskinesia, akathisia, neuroleptic malignant syndrome, and extrapyramidal symptoms.
10) What are the contraindications for use of olanzapine including significant drug to drug interactions? Case Study For Psychosis And Schizophrenia Assignment
Contraindicated in patients who are hypersensitive to drugs within the same class; Increases risk of mortality when used in patients with dementia-related psychosis.
11) What should be done in case a patient takes an overdose of olanzapine?
Low toxicity potential if administered alone; causes toxicity if taken with other medications.
For acute overdose, maintain an airway, provide adequate oxygenation; consider administration of activated charcoal and gastric lavage; cardiovascular monitoring.
12) What is the diagnosis of overdose and the subsequent labs monitoring?
Clinical manifestations of toxicity include agitation, coma, delirium, sedation, dysarthria, aspiration, convulsions, and respiratory depression; laboratory monitoring-respiratory rate, diabetes, and heart rate.
13) What are the comorbid considerations for olanzapine?
Increased risk of blood glucose, diabetes, hyperglycaemia, ketoacidosis, coma, dyskinesis movements, anticholinergic effects, Neutropenia, agranulocytosis and leukopenia; increased risk of diabetes and weight gain; patient may experience cerebrovascular effects such as transient ischemic attack and stroke that may result in death.

Fig 4: Effect of olanzapine on weight gain (Correll et al., 2020)
14) What are legal and ethical considerations for prescribing the medication?
FDA prohibits the off-label use of the medication among elderly patients with dementia (Gheisarzadeh, 2019)Case Study For Psychosis And Schizophrenia Assignment; Use with caution in patients with a history of seizures; Use with caution among patients at risk of pneumonia;
15) What are the pertinent patient education considerations for olanzapine?
Patients should know that the drug may cause dizziness, fainting, slow heartbeat, and light-headedness. Patients using the drug should also monitor glucose and cholesterol levels.

References
García, A., Monsalve, M., Doblado, L., & Kramar, B. (2019). Mechanisms of action of antipsychotic drugs Aripiprazole and Olanzapine on mitochondrial dynamics in liver cells.
Gheisarzadeh, N. (2019). Off-Label Use of Second Generation Antipsychotics in Primary Care-An Exploratory Study. https://ir.lib.uwo.ca/etd/6467
Grover, S., & Avasthi, A. (2019). Clinical practice guidelines for the management of schizophrenia in children and adolescents. Indian Journal of Psychiatry, 61(Suppl 2), 277.

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https://doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_556_18
Monahan, C., McCoy, L., Powell, J., & Gums, J. G. (2022). Olanzapine/Samidorphan: New Drug Approved for Treating Bipolar I Disorder and Schizophrenia. Annals of Pharmacotherapy, 10600280211070330.
Reboucas, C. V. D., Alves, R. D. B., Yamada, A. M. T. D., Vidal Brito, T., Del Giglio, A., & Cruz, F. M. (2022). Efficacy of olanzapine, netupitant, and palonosetron in controlling nausea and vomiting associated with highly emetogenic chemotherapy in patients with breast cancer (OLNEPA). https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.12104
Thomas, K., & Saadabadi, A. (2018). Olanzapine.
Correll, C. U., Newcomer, J. W., Silverman, B., DiPetrillo, L., Graham, C., Jiang, Y., … & Kahn, R. S. (2020). Effects of olanzapine combined with samidorphan on weight gain in schizophrenia: a 24-week phase 3 study. American Journal of Psychiatry, 177(12), 1168-1178 Case Study For Psychosis And Schizophrenia Assignment