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Select one drug to treat the diagnosis(es) or symptoms
Clozapine (Clozaril)
List medication class and mechanism of action for the chosen medication.
Atypical antipsychotic (serotonin-dopamine antagonist; second-generation antipsychotic; also a mood stabilizer)
Write the prescription in prescription formal.
25 mg tablet, once daily at night PO
Provide an evidence-based rationale for the selected medication using at least one scholarly reference. Textbooks may be used for additional references but are not the primary reference.
Clozapine has surfaced as one of the most effective treatments for schizophrenia. Unlike other atypical antipsychotics, Clozapine does not just bind heavily to dopamine receptors but across multiple neurotransmitter symptoms including serotonergic, noradrenergic and glutamatergic receptors (Kohkar et al., 2018). Because of Clozapine’s uniqueness in neurotransmitter targets leading to better prognosis with patients, other medications have risen up such as serotonin 5-HT2A and dopamine D2 receptors
List any side effects or adverse effects associated with the medication.
Common side effects include orthostasis, sialorrhea, constipation, sedation, tachycardia, weight gain, dylipidemia/hyperglycemia, benign fever, and possibly tar dive dyskinesia. Tardive dyskinesia is less common in their medication compared to others antipsychotics and may become irreversible dependent on cumulative dose and length of treatment.
Life threatening side effects may be severe neutropenia, myocarditis (in the first 6 weeks of treatment), paralytic lieu’s, seizures, hyperglycemia as far as DKA, pulmonary embolism, and dilated cardiomyopathy. Individuals have also gone through rare neuroleptic malignant syndrome (NMS).
Include any required diagnostic testing. State the time frame for this testing (testing is before medication initiation or q 3 months, etc.). Includes normal results range for any listed laboratory tests.
Baseline absolute neutrophil count (ANC) is to be obtained prior to therapy and should be at least 1500/uL. 1000-1499/uL is considered mild neutropenia and treatment is usually continued within this range. 500-999/uL is considered moderate neutropenia and treatment should be stopped for suspected Clozapine-induced neutropenia. This monitoring should be done weekly in the first 6 months, bi-weekly in the second 6 months, and monthly after 1 year.
Are Provide a minimum of three appropriate medication-related teaching points for the client and/or family.
Do not stop medication abruptly, This can lead to rebound psychosis and worsening of symptoms. Patient should also be monitored for cholinergic rebound .
Take at bedtime to reduce daytime sedation.
Maintain a healthy lifestyle management and exercise regimen to avoid weight gain.
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Instructions– Engage by offering new insights, applications, perspectives, information, or implications for practice for the information read above.
a. Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.
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Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
Reference Citation: Use current APA format to format citations and references and is free of errors. Only 1 paragraph is needed. Response to the above with why you wouldn’t choose this medication as the first-generation antipsychotic agent for schizophrenia. Talk about how when writing my paper I was trying to decided which drug to choose and this one came to mind but I ended up choosing Aripiprazole (Abilify) and how I didn’t chose Clozapine (Clozaril) for schizophrenia and why. Provide 2 referenced with one being the reference below. References must be 7TH EDITION. APA within 5 years.
3. Stahl, S. M. (2021a). Stahl’s Essential Psychopharmacology: Prescriber’s Guide, 7th ed.
Chamberlain University Press.
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