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Case Study: Pakistani Woman with Delusional Thoughts

Student’s Name

Institutional Affiliation

Course

Date
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Introduction

The patient migrated to the United States from Pakistan during her teenage years. She is

married under the force of her family's whims. After a 21-day stay in the healthcare facility for

what was classified as a short psychotic episode, she shows up at the department. Since her

complaints have lasted not more than 30 days, she was diagnosed with this condition. For a week

before her hospitalization, she reported seeing glimpses of Allah and thought she was

Muhammad. Because of her faith in her, she imagined she could save humanity from its

depravity. Her husband was terrified to leave their four kids alone due to this demeanor, which

worried him greatly. One night, she became uncontrollable, and as a consequence, his spouse

called the police, and she was taken to an acute psychiatric ward. She believes that the situation

was exaggerated in the course of the evaluation. Despite his claims to the contrary, he insists that

his spouse was never his soulmate, and he desired an American bride in her place. She stands at

5'5" and weighs 140 pounds. The patient testifies she's in a terrific attitude. Despite her denials,

she is convinced that Tv converses with her. She thinks the Almighty communicates with her via

the television. According to her patient records, she was previously examined by a doctor who

found her to be in excellent condition. Thoughts are characterized by psychosis and paranoia, as

previously said. The ability to think clearly and make sound decisions are seriously hampered.

She constantly denies having depressive or murderous thoughts. The patient is experiencing

a short psychotic condition which took her 21-day inpatient treatment. It’s apparent that the

problem has endured for several weeks. The Adequate judgment must be established in this

instances to guarantee adequate handling of the customer. The psychotic disease is created by the

circumstance that she forcibly married a man whose marital plans were arranged while she was

9-years old. The patient psychotic syndrome appears to have not grown to intense degrees
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because she is aware, attentive to people, moment, location and occurrences. The customer is

well clothed. But at the other side, she portrays signs of deterioration such as continuous

intervals of stillness, attitudes of nonpsychotic and low speaking. The decisions articulated

below are taken in her therapeutic approaches.

Decision #1

I Choose Start Zyprexa 10 mg orally at bedtime. Schizophrenia patients can benefit from

antipsychotic medication, which reduces the chance of recurrence and improves positive signs. A

2nd-generation schizophrenia medication, Zyprexa, was validated by the Food and Drug

Administration (FDA) in 1996 as a thienobenzodiazepine precursor (Kay, Fiszbein, & Opler,

1987). Psychosis impacts an individual's thoughts, feelings and actions. Some of the most

obvious signs are illusions, paranoid delusions and cognitive difficulties and cognition. Psychotic

abnormalities, including strange postures and personality, are also commonly seen in people with

schizophrenia (Sun et al., 2014). As a key component of the condition, cognitive impairment,

such as a diminished capacity to remain focused and a deficiency in quick non-verbal memory, is

a significant predictor of disability. 2.50 milligrams to 10 milligrams, 10 milligrams to 20

milligrams or above 20 milligrams orally once per day is recommended for schizophrenia

patients taking Zyprexa orally (Levenson, Kay, & Buysse, 2015). Several cerebral

neurotransmission circuits and interconnections affected by psychosis involve gamma-

aminobutyric acid, dopamine, serotonin, and glutamate. It is a strong inhibitor of serotoninergic

transmitters, such as the 5-HT2B, 5-HT2A, and 5-HT2C neurotransmitters and the histamine H1

and alpha-1 adrenal neurotransmitters (Sun et al., 2014). It's less effective as a cholinergic and

dopamine D1 channel inhibitor because of its lower efficacy. As contrasted to various

antipsychotics, Zyprexa was therapeutically beneficial, with enhanced health outcomes and
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decreased risk of neurogenic manifestations (Lin et al., 2014). Zyprexa dosage of 10 milligrams

to 15 milligrams per day has been shown to be most effective; nonsmoking ladies may benefit

from relatively low doses as milligrams each day (Kay, Fiszbein, & Opler, 1987). Zyprexa could

be prescribed in higher or lower doses, and the link regarding Zyprexa dosage, effectiveness and

harmful impacts is inconsistent among investigations (Keepers et al., 2020). Small dosages of

Zyprexa had little effect on the quality of life for those with psychosis, whereas high and

medium dosages showed significant benefits.

Decision #2

I choose to change medication to Geodon 40 mg orally BID with meals. Geodon is a

contemporary unconventional or secondary-innovation antipsychotic. Oral Geodon was licensed

by the United States Food and Drug Administration (FDA) in the clinical therapy of

schizophrenia and severe mixed or manic episodes related to a bipolar abnormality with or

without the presence of psychotic symptoms (Sun et al., 2014). Conceptual analysis shows that

Geodon's safety and effectiveness in therapeutic interventions are higher than other secondary-

innovation antipsychotic medications, such as aripiprazole or quetiapine (Kay, Fiszbein, &

Opler, 1987). An essential consideration regarding Geodon utility characteristic is the dosage

escalation process and attained dosage. A recommended dosage combination of 120-160

milligrams per day is linked to better overall symptomatic relief and longer therapeutic response.

Furthermore, raising Geodon's efficiency involves assuring that the medicine is delivered

together with a 500 kcal diet; else, uptake of oral Geodon is significantly diminished and can't be

accounted for by raising the prescription dosage (Sun et al., 2014). Pertaining biocompatibility,

Geodon has key benefits since it's not affiliated with clinically massive weight gains or

complications related to cholesterol, glycemic control triacylglycerol, and care recipients could
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face moderately improved performance in these approaches when transitioning to Geodon from a

dissimilar antipsychotic (Sun et al., 2014). Geodon likewise doesn't have significant permanent

impacts on plasma concentrations, is not anticholinergic, and infrequently causes

neuropsychiatric adverse effects or axial organ dysfunction; nonetheless, it could be linked with

drowsiness (Lin et al., 2014). Geodon may lengthen the electrocardiogram (ECG) QT sequence,

but this does not seem to constitute a serious medical concern. Given that a sufficient dosage of

Geodon is offered and taken with a 500 kcal dinner, the drug can be efficiently utilized to

manage complaints in the absence of the enduring dangers of negative metabolic effects

(Levenson, Kay, & Buysse, 2015). Geodon has been demonstrated to be a therapeutically

appropriate medication in managing patients with psychosis or with a manic experience. Its key

benefit over other secondary-innovation antipsychotics is the augmented biochemical capability.

Decision #3

I choose: to change the Geodon to 80mg at bedtime daily and monitor for breakthrough

symptoms throughout the day. The fundamental therapeutic objective for mental disorders is

rehabilitating a person to a meaningful life, preferably encompassing functional independence,

community engagement and involvement in job or studies (Sun et al., 2014). A combination of

drugs is currently available, bringing novel therapeutic choices and prompting enhanced

confidence for enhanced medical results. Guided by its target composition, Geodon presents a

variety of actions indicative of effectiveness and tolerance (Kay, Fiszbein, & Opler, 1987).

Contrasting with various first-line psychiatric drugs, Geodon has more diversified

neurotransmission properties and a substantially diminished burden of M1 and H1 antagonist

and alpha 1-adrenergic activity. The therapeutic advantages of this transcription factor

characteristics modulation of neuropsychiatric signs, reduced prevalence of EPS, excess weight,

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and postural dizziness have been documented in randomized management attempts (Levenson,

Kay, & Buysse, 2015). Because Geodon and different atypical pharmacologic medications are

not cognitive enhancers and don't generate the immediate and powerful reactions that doctors

need when dealing with clients experiencing acute and burdensome problems, stronger

medications for psychosis are still necessary (Lin et al., 2014). In comparison to olanzapine,

risperidone, and quetiapine, Geodon has shown to have a lower tendency to cause excess weight

and accompanying biochemical issues, like an upsurge in triglycerides (Sun et al., 2014).

Suppose antipsychotics like Geodon need to effectively treat the range of indications associated

with schizophrenia and aid patients fit in significant human life. In that case, it is necessary to

examine controlled trials and the existing skills of the patients to unveil which distinctive people

are better suited to particular antipsychotics like Geodon.

Conclusion

The health condition method can be performed to the evaluation of numerous therapies

for therapeutically multifaceted conditions like psychosis and generate new insights into

disparities in the general well-being of patients results. SGAs as a category seem to not be

manifestly preferable to perphenazine, a transitional strength FGA (Sun et al., 2014). The

constant emergence of innovative SGA's exhibiting closely resembling processes, signs and

consequence patterns may make it increasingly complicated for physicians to determine the best

effective therapy for customers (Keepers et al., 2020). Recommendations about a person's vigor

can be made better by emphasizing health condition evaluation. It's still unclear how

psychotherapies from the first and second generations affect general cognitive well-being and

manifestations in those with psychosis (Levenson, Kay, & Buysse, 2015). Health status

assessment can give insight into the general medical condition of individuals far beyond the
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basic contrast of average results. Second-generation antipsychotics (SGAs) have raised

clinicians' enthusiasm because schizophrenia is a common cause of disease-linked impairment.

SGAs can hardly be regarded as a separate pharmaceutical category because every SGA has

several complicated physiologic activities, merely several of which are identical to different

SGAs (Sun et al., 2014). Although numerous antipsychotics have ordinarily equal effectiveness,

doctors can get better than a standard performance by evaluating distinctions in picking a

particular medicine for a given client. Therapists are well aware that every client is an individual.

The greatest treatment is specifically personalized to each customer to attain the most preferred

results possible.
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References

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale

(PANSS) for Schizophrenia. Schizophrenia Bulletin, 13(2), 261–276.

https://doi.org/10.1093/schbul/13.2.261

Keepers, G. A. et al., (2020). The American Psychiatric Association Practice Guideline for the

Treatment of Patients With Schizophrenia. American Journal of Psychiatry.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.177901

Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The Pathophysiology of Insomnia. Chest,

147(4), 1179–1192. https://doi.org/10.1378/chest.14-1617

Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2014). Comparing Antipsychotic

Treatments for Schizophrenia: A Health State Approach. Psychiatric Quarterly, 86(1),

107–121. https://doi.org/10.1007/s11126-014-9326-2

Sun, F., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B.

(2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in

multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728–

738. https://doi.org/10.2146/ajhp130471