Evaluating and managing the side effects of psychotropics
is an important part of prescribing. Some side effects can be safely monitored
and managed by a PMHNP. While others may require additional tests,
collaboration with primary care providers, or even referrals to specialists. It
is key to know which side effects are “ok” to treat and which should really be
treated by a different provider. Part of this answer may depend on the state in
which you ultimately practice, as what you are allowed to prescribe may vary
state by state.
For this assignment, you will review the PowerPoint
•
Evaluating and Managing Side Effects of Psychiatric Medications ***See attached file***
The answers to these questions will be located in the
PowerPoint, but you will need to do additional research to support your
decisions.
Please read the following and address the questions:
• A 56
yr. old woman signs up with you as his new primary care physician. Her previous
diagnosis included hyperlipidemia, hyperglycemia, moderate obesity and
hypertension. His medications include: Paroxetine 20 mg for 10 years;
Quetiapine 150 mg daily for 2 yrs.; Irbesartan 300 mg daily for 1 yr.; and
Atorvastatin 10 mg daily for 1 yr.
• Labs:
FBS = 126, HgbA1C = 6.2, total cholesterol = 200, LDL = 105, HDL = 35, Tg =286.
His present height equal 5’9” and weight = 210 lbs. His BP is 140/84.
• She
tells you that about 10 yrs. ago she became depressed and was started on
Paroxetine and gained 30lbs after 1 yr. Her mood at that time was much improved
and remained that way for about 2 yrs. At that time, Quetiapine was added, and
she achieved remission of her depression. Six months after this she gained
another 20lbs, developed mild hypertension, hyperglycemia and hyperlipidemia.
All other lab including thyroid testing was normal. She tells you that she has
a craving for carbohydrates and does little exercise since developing
depression about 15 yrs. ago.
Questions:
• What
advice or modifications to his treatment regimen would you recommend for your
new patient? (Discuss a minimum of two). Please support your answer with
research-based evidence.
• If you
suggested additional medication, look up your state’s prescribing laws. Are
PMHNP’s able to prescribe the medication you recommended?
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