Psychotropic Medications

(DoH, 2005, p8). A diagnosis and treatment plan is agreed on by the independent prescriber and from this the supplementary prescriber can review and amend doses as seen appropriate with the patient. DoH (2005) initially suggested supplementary prescribing was more appropriate for a longer-term setting because an agreed CMP is required prior to prescribing. Nuttall & Rutt-Howard (2011) states many professionals often feel limited in supplementary prescribing as they are boundaried by the CMP. By adopting this outlook, patient’s presentations in the longer-term setting would then be classed as all being uncomplicated and predictable. DoH (2005) reports supplementary prescribing allows clinicians to develop their confidence. By understanding not all patients are the same and that complex cases are common, the supplementary prescriber can therefore exercise skills in observing and reviewing any changes in clients and report back to the independent prescriber in a safe manner and develop their

The pharmacist must offer to discuss the unique drug therapy regimen of each Medicaid recipient when filling prescriptions for them. Each patient must be made an offer to be counseled by the pharmacist. The items to be addressed include, the name of the drug, intended use of expected action, common side effects and their avoidance, techniques for self-monitoring, proper storage, potential drug-drug or drug-food contraindications, refill

This paper will demonstrate the author’s ability to prescribe safely from the Nurse Prescribing Formulary (NPF 2009-2011). A prescribing situation undertaken by myself while supervised by my mentor will be discussed. The patients name, address, date of birth and GP details have been changed to ensure patient confidentiality in accordance with the Nursing and Midwifery Council (NMC)(2004). The patient therefore will be referred to under the pseudonym Prince Charming.

If the patient meets all requirements and is mentally stable, a prescription for the medication may be written and the patient may take the medication.

In order to progress further following discussion with Lisa under my mentor supervision as a CPNP V100 I made a prescribing decision based on the physical examination and the information provided I

Discuss one treatment concern that the NP will have relative to the potential for dependence and/or withdrawal in the patient and why?(20pts)

Medications are a necessity in dealing with this illness. Anti-psychotics are predominant in the copious amounts of prescriptions that are written for the diagnosed. My experience in the school setting, summer proves to be a season for change as parents use this time to stop or change dosages of medications without doctor advice or approval. Although “regular classes” are not in session, summer school classes can be faced as a challenge when necessary medications have not been taken. I have learned at my practicum site, adult patients in the clinic have taken to self-medicating, adding in marijuana and other street drugs, either in addition or instead of the doctor prescribed medications. Removing one or more drugs from the cocktail that the doctor prescribed can create a windfall of problems for the patients. In stopping and restarting anti-psychotic medication, the patient runs the risk of relapse of symptoms, sometimes worse than they were

As we have seen, treatment of schizophrenia with antipsychotic drugs can have impressive results in terms of decreasing active symptoms, although it does nothing to alleviate negative symptoms or to improve cognitive functioning. Unfortunately, this kind of treatment has the drawback of extremely serious and even fatal side-effects. Newer generation atypical antipsychotics offer more hope, as they can treat both active and negative symptoms, and also improve cognitive functioning. Moreover, they have fewer side-effects. However, treatment is complicated by the fact that results are unpredictable; and in addition the side-effects that they do have can be very serious, such as diabetes, which in itself is life-threatening. However, as the potential side-effects are known, the physician has leeway to choose a drug which is a good match for the patient’s clinical profile. Then, once the patient’s symptoms have been much alleviated with an appropriate newer generation atypical antipsychotic, the patient should be able to also benefit from a range of psychotherapeutic interventions. It is argued that this is the best treatment regime to choose, as it is likely to result in the greatest improvement in quality of life, coupled with the lowest risk of potentially devastating side-effects, or of death. This is likely to be better than utilizing cognitive behavioral therapy, the results of which are not reliably known – although research has certainly shown that it is less efficacious

On the other hand, I understand the matter of prn pain medication abuse. Again, the patient’s expression of pain is the sole indicator, so it is important to respond. Potash (2010) suggest a health history and exploring the patient’s past and identify if anything can be a trigger. Further, it’s important to try trial and error because the current medication, is not providing a therapeutic effect for the pain. As a result, figuring out a new balance, perhaps discontinuing a medication and prescribing one with a higher therapeutic window. Also, daily pain assessments to evaluate the effectiveness of the new pain. The primary focus is decreasing the pain.

Therapy for psychosis often works best when combined with medication, although this is not always

I learnt that using anti-psychotics is just a component of a holistic approach to a patient with psychotic illness and that care should also include psychological treatments

In the book Psychiatric Drug Withdrawal, Dr. Peter R. Breggin Breggin establishes guidelines to assist prescribers and therapists in withdrawing their patients from psychiatric drugs, including those patients with long-term exposure to antipsychotic drugs, benzodiazepines, stimulants, antidepressants, and mood stabilizers. He asserts that pharmaceutical companies along with the influence of managed care in health care settings have led to psychiatric medication being considered the answer to address mental illness. Dr. Breggin utilizes years of clinical experience, discussions with colleagues, and research to develop this insight. This insight is highly beneficial to aspiring practitioners and practicing professionals in five distinct ways. It helps to practitioners to recognize common and sometimes overlooked adverse drug effects that may

Antipsychotics are classified as major tranquilizers that are used to treat mental health illnesses such as schizophrenia, bipolar disorder, and other mental illnesses. They can also treat severe depression and severe anxiety. These antipsychotics drugs reduce or increase the effect of neurotransmitters in the brain to regulate levels that help transfer information throughout the brain. The neurotransmitters that are affected are the serotonin, dopamine, and noradrenaline.

A commissioned report by National Collaborating Centre for Mental Health (NCCMH, 2008) by National Institute for Health and Care Excellence (NICE) and a recent 8-year review of the aforementioned (NICE, 2016) inform current NICE guidelines including referrals to 12-step (NICE, 2007). The current evidence base (NCCMH, 2008) uses a systematic review of the literature (McAuliffe, 1990, Etheridge et al., 1999, Moos et al., 1999, Fiorentine and Hillhouse, 2000, Toumbourou et al., 2002, Weiss et al., 2005, Timko et al., 2006).

Deglin, J.H., & Vallerand, A.H. (2005). Davi’s Drug Guide for Nurses 9th Edition. Philadelphia, PA: F.A. Davis Company.