Schizophrenia is a severe psychological disorder that impacts the ability of a person to feel, think, and behave clearly. This disease is characterized by a wide range of symptoms, such as hallucinations, bizarre thoughts, and psychosocial functioning. Schizophrenia is a collective functional psychosis, and significant erraticism happens in the medical presentation. During the episodes of acute psychotic, the patients are unable to recognize reality, and the brain develops a fake realism to substitute it (Lieberman & Murray, 2012).
Pharmacotherapy is a therapeutic process of using pharmaceutical drugs to treat schizophrenia. It is challenging to execute an effective psychosocial rehabilitation program for most patients without integrating the antipsychotic treatment (Stahl, 2013). Therefore caregivers should create a unique treatment plan for every patient which has clear defined endpoints and contains fundamental objectives for the target symptoms. The main aim of this paper is to develop a precise treatment plan for a patient diagnosed with Schizophrenia and ethical concerns that should be included in the treatment plan.
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Decision point one
Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day four and monthly after that
Paliperidone is a strange neuroleptic medicine that is used to cure schizophrenia. Since it is the lively primary metabolite of risperidone, the therapeutic effectiveness of Paliperidone is assumed to start from the mixed fundamental serotonergic and dopaminergic antagonism. That is the drug function by altering the effects of a chemical in the brain. Paliperidone contains low affinity for muscarinic receptors and high affinity to 5-HT2A, H1, and D2 receptors (Stahl, 2014). Although the rest options can be classified as viable alternatives, in this case, the main concern is compliance. The patient acknowledged having discontinued her oral medication before the prescribed time.
Invega Sustenna is intramuscular depot injection which is administered every month and provides the best solution on the issue of compliance. The expected result from this therapy is to normalize patient’s eating and sleep disorder, reduce anxiety, agitation, aggression, and hostility. When the client visited the clinic after four weeks, the Schizophrenia symptoms have decreased by 25%, this was in line with the treatment objective and proved the treatment plan was viable. However, the only slight difference between the expected and actual result is that the client complained of pain and inconveniences caused by the injection and she had gained weight by 2 pounds this was triggered an increase in patient appetite. Since the client did not show significant concerns, it recommended continuing improving the response.
Decision Point 2
Progress with the same treatment plan but recommend the administering nurse to start injections into the deltoid from this visit and onward.
According to Rothschild (2014), if the patient starts to show a satisfactory response when administered with a specific dose, she should continue taking the dosage as long as the symptoms keep decreasing. At this stage, the main treatment concern is reducing the pain which the client is experiencing after injection and that why we change the site of injection since it will help the patient to corporate and accept the treatment program. Furthermore, it will help the patient to carry out his daily activities with minimal distractions. The expected results are that the patient shall be able to take care of herself, socialize, in a friendly manner, and can regulate her mood with a 50% percent reduction in Schizophrenia symptoms. Upon visiting the clinic after four weeks, the patient symptoms have significantly improved and are in line with the expectation. The only differences between the expected and actual result are that the client weight has increased by three pounds.
Decision Point Three
Continue with Invega Sustenna treatment plan. However, advice the client that weight gain arising from Invega Sustenna is little as compared with other drugs which have the same efficacy can cause. Make an appointment with an exercise psychologist and dietician and carry out a follow up in one month.
Invega Sustenna drug is attributed to cause weight gain. However, the problem of weight gain can be controlled using the proper exercise and nutrition plan (Lin et al., 2015). The patient should be administered with Invega Sustenna drug for at least six months together with a controlled exercise and diet plan to reduce weight gain. The expected result is to avoid undesirable side effects, prevent relapse, integrate the patient back into the community, and increase her adaptive functioning. After four weeks the patient's symptoms had reduced significantly, and there was no variance between the expected and actual result
Ethical Consideration That Might Impact the Treatment Plan
Physicians taking care of patients with schizophrenia disorder may experience a range of ethical issues linked to both psychiatric medical care of patients. A well-versed agreement may present exceptional problems for clients with schizophrenia disorder due to the additional neuropsychological discrepancies. These differences can impact the capability of a patient to make informed judgments about their health. Therefore the ethical principles underlying the treatment of a patient with schizophrenia should be well outlined in the treatment plan to avoid any form of conflict.
References
Lieberman, J. A., & Murray, R. M. (2012). Comprehensive care of schizophrenia: A textbook of clinical management. Oxford: Oxford University Press.
Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. Psychiatric Quarterly, 86(1), 107-121
Rothschild, A. J. (2013). The evidence-based guide to antipsychotic medications. Washington, DC: American Psychiatric Pub.
Stahl, S. M., & Grady, M. M. (2014). Stahl's essential psychopharmacology: The prescriber's guide. Cambridge, UK: Cambridge University Press.
Stahl, S. M. (2013). Stahl's essential psychopharmacology: neuroscientific basis and practical applications. Cambridge university press.
