Case Study: Mood and Behavioral Disorders

A patient has bipolar disorder. She was just started on Lithium. She is also on paroxetine (Paxil) and furosemide (Lasix). The patient has heart failure, so she is also on a low sodium diet.

a) What should you be watching for on the first 3 weeks of Lithium?

b) The therapeutic range for Lithium is 0.6-1.5mEq/L. Explain why maintaining this level is important?

c) How might using Lithium, along with a diuretic and being on a low sodium diet impact the patient?

d) What class of medication is Paxil? wWhat is the mechanism of action for this type of drug?

List the side effects of Paxil.

e) As a health care worker what are your goals for this patient? (think about symptoms, lithium levels, side effects and patient needs)


John is a 7 year old boy who was diagnosed with ADHD. He is having trouble in school as he does not hand in his homework, interrupts the teacher during class by blurting out answers and inappropriate comments, leaves his seat during tests, and is always losing his pencil and books.

What are two typical CNS stimulant medications that might be used to treat ADHD?

What are their side effects?

What controlled substance schedule do they belong to?

What is an example of a non-stimulant medication to treat ADHD and why would a non- stimulant be selected?

What nonpharmacologic interventions could you suggest to the patient and his caregivers

Case Study: Psychoses

A patient has been taking chlorpromazine/Thorazine for about a year. He has been having problems with orthostatic hypotension and akathisia. He has needed to take Cogentin to avoid dystonic reactions. The physician has decided to change him to Clozaril.

Describe the following: orthostatic hypotension, akathisia, dystonia

What class of antipsychotic medications does chlorpromazine belong to?

(Stating antipsychotics is not sufficient-specify the class).

Provide a brief explanation about what this medication is used for and its benefits.

b) What are some of the side effects of chlorpromazine?

What type of medication is Cogentin and how will it help this patient’s dystonia?

What are the advantages of using Clozaril over chlorpromazine?

What are some of the major disadvantages of Clozaril? You must discuss both.


Case Study: Drugs for Degenerative Diseases and Muscles

Mark is a 20 year old patient with cerebral palsy. He has spasticity, muscle spasms, contractures of his muscles, and demonstrates scissoring. He is currently on baclofen/Lioresal and tizanidine/Zanaflex. His mother asks you if cyclobenzaprine/Flexeril might be a good choice to help Mark with his spasticity and muscle spasms. She is concerned that Mark always appears drowsy and fatigued. She also reports that he seems to always have a dry mouth and be constipated. She says that she heard Botox injections help people with spasticity. She wants to know if Botox is safe to use and is a possibility for Mark.

List some nonpharmacologic therapies that may be useful for Mark?

What class of medications are Lioresal and Zanaflex?

Describe their mechanism of action/how they work

Explain why you think this patient may be drowsy and fatigued, why may he have dry mouth and be constipated?

your answer should discuss why Mark has these side effects in terms of the medications he is currently on

What class of medication in cyclobenzaprine/Flexeril?

Describe its mechanism of action and side effects

Is this a recommended medication for Mark’s condition?

What should you tell Mark’s mother about the use of this medication for her son?

What class of medication Botox?

Describe its mechanism of action

Do you think this drug is a good option for Mark? your answer should consider side effects/usefulness of this type of drug treatment in light of Mark’s condition

What can you tell Mark’s mother about the use of Botox for muscle relaxation?

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