NR 546 Week 3 Discussion.
Dr. Okpaleke and Class,
In the case of LM presenting with chief complaints of hearing voices with no past psychiatric
history but a positive family history of suicide and substance abuse. LM is diagnosed with F20.9
Schizophrenia, unspecified. According to Stahl (2021), psychosis is a syndrome with a mixture
of symptoms that can be associated with different psychiatric disorders. Furthermore, it has been
said that psychosis is means delusions and hallucinations. Hallucinations are perceptual
experiences of any sensory modality, especially auditory, according to Stahl (2021).
The APA (2021) recommends the use of second-generation antipsychotic medication for stable
patients presenting to outpatient settings, while recommending first generation antipsychotics for
unstable inpatient use. Therefore, I chose Chlorpromazine for its therapeutic use as an oral agent
for schizophrenia. Chlorpromazine is a conventional antipsychotic which works as a dopamine
and serotonin receptor antagonist (DS-Ran), according to Stahl (2020).
The prescription for this medication should be written as such; patient name: LM, date of birth
01/01/1984, NKDA, Drug: Chlorpromazine 25mg tablet by mouth every six hours for 2 weeks.
Prescribers name and credentials, signature and date of prescribing.
Chlorpromazine has been used in treating Schizophrenia’s positive symptoms and is used to
manage and treat schizophrenia, bipolar disorders, and acute psychosis, according to Mann &
Marwaha (2021).
According to Stahl (2020), side effects of Chlorpromazine are dose related, however the notable
side effects are dizziness, sedation, impaired memory, dry mouth, constipation, urinary retention,
blurred vision, decreased sweating, sexual dysfunction, weight gain, and tardive dyskinesia.
The required diagnostic testing for Chlorpromazine includes obtaining baseline weight and BMI
of patient, obtaining baseline diabetes testing such as fasting plasma glucose, as well as testing
baseline lipid panel, obtain baseline metabolic panel, complete blood count and prolactin levels,
and finally, obtain baseline vital signs and monitor for abnormal movements of tardive
dyskinesia. Normal fasting glucose should be 100-125mg/dl, cholesterol levels should be less
than 200mg/dl, normal white count should be less than 11000 wbc per microliter. There should
not be any abnormal movements in assessing for tardive dyskinesia.
Teaching for Chlorpromazine should include education on side effects, education on monitoring
for tardive dyskinesia, monitoring weight gain, not taking Chlorpromazine with other CNS
depressive substances such as alcohol, signs of allergies to Chlorpromazine such as facial
swelling, worsening respiratory status, confusion, or comatose state. Chlorpromazine may cause
postural hypotension so to get up slowly from bed or chair. Avoid extreme heat or undue
exposure to sunlight.
Dr. Okpaleke and Class,
In the case of LM presenting with chief complaints of hearing voices with no past psychiatric
history but a positive family history of suicide and substance abuse. LM is diagnosed with F20.9
Schizophrenia, unspecified. According to Stahl (2021), psychosis is a syndrome with a mixture
of symptoms that can be associated with different psychiatric disorders. Furthermore, it has been
said that psychosis is means delusions and hallucinations. Hallucinations are perceptual
experiences of any sensory modality, especially auditory, according to Stahl (2021).
The APA (2021) recommends the use of second-generation antipsychotic medication for stable
patients presenting to outpatient settings, while recommending first generation antipsychotics for
unstable inpatient use. Therefore, I chose Chlorpromazine for its therapeutic use as an oral agent
for schizophrenia. Chlorpromazine is a conventional antipsychotic which works as a dopamine
and serotonin receptor antagonist (DS-Ran), according to Stahl (2020).
The prescription for this medication should be written as such; patient name: LM, date of birth
01/01/1984, NKDA, Drug: Chlorpromazine 25mg tablet by mouth every six hours for 2 weeks.
Prescribers name and credentials, signature and date of prescribing.
Chlorpromazine has been used in treating Schizophrenia’s positive symptoms and is used to
manage and treat schizophrenia, bipolar disorders, and acute psychosis, according to Mann &
Marwaha (2021).
According to Stahl (2020), side effects of Chlorpromazine are dose related, however the notable
side effects are dizziness, sedation, impaired memory, dry mouth, constipation, urinary retention,
blurred vision, decreased sweating, sexual dysfunction, weight gain, and tardive dyskinesia.
The required diagnostic testing for Chlorpromazine includes obtaining baseline weight and BMI
of patient, obtaining baseline diabetes testing such as fasting plasma glucose, as well as testing
baseline lipid panel, obtain baseline metabolic panel, complete blood count and prolactin levels,
and finally, obtain baseline vital signs and monitor for abnormal movements of tardive
dyskinesia. Normal fasting glucose should be 100-125mg/dl, cholesterol levels should be less
than 200mg/dl, normal white count should be less than 11000 wbc per microliter. There should
not be any abnormal movements in assessing for tardive dyskinesia.
Teaching for Chlorpromazine should include education on side effects, education on monitoring
for tardive dyskinesia, monitoring weight gain, not taking Chlorpromazine with other CNS
depressive substances such as alcohol, signs of allergies to Chlorpromazine such as facial
swelling, worsening respiratory status, confusion, or comatose state. Chlorpromazine may cause
postural hypotension so to get up slowly from bed or chair. Avoid extreme heat or undue
exposure to sunlight.
