Patient Encounter Part 4

With his care providers, AC discussed several possible medication choices. Because there had been improvement of auditory hallucinations on risperidone, the initial choice was made to increase the dose to target the ongoing paranoid thinking. AC was seen weekly to monitor for emergence of EPS or akathisia. He was able to tolerate an increase to 4 mg of risperidone daily with improvement in his paranoid thinking. He went on several job interviews and accepted part-time employment at a coffee shop. When he complained of emergence of sexual dysfunction, his prolactin level was determined to be 42 ng/mL (42 mcg/L) (normal prolactin levels are less than or equal to 18-20 ng/mL [18-20 mcg/L] in men and less than or equal to 24 ng/mL [24 mcg/ L] in women). He discussed risks and benefits of therapy with his clinicians and decided to continue risperidone for now, as he had improved in his ability to work and get out more in the community. He remains interested in having an aripiprazole trial in the future, as he hopes he might more easily lose the weight he gained while taking olanzapine and resume normal sexual functioning. He is no longer taking an antide-pressant, and though he has some low days, he does not meet the criteria for diagnosis of depressive episode. He continues to be free of substance abuse, and his girlfriend continues to support his treatment. He still hopes to return to work in his field of expertise someday.

Based on the information above, create a care plan for this patient's treatment. Your plan should include: (a) a statement of the drug-related concerns and/or problems, (b) the goals of therapy, and (c) a plan for monitoring andfollow-up to determine whether the goals have been achieved and adverse effects minimized.

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