Study Guide for Medication Treatment Schizophrenia Spectrum and Other Psychosis Disorders

Study Guide for Medication Treatment Schizophrenia Spectrum and Other Psychosis Disorders

Psychotic disorders are an amalgam of mental health illnesses that cause a loss of contact with reality. Schizophrenia is an example of a psychosis that is characterized by delusions, hallucinations, and disturbances in thought processes and behavior (Hany et al., 2022). Antipsychotic medications maintain effectiveness in the management of schizophrenia and other psychotic disorders. This study guide outlines a medication used to treat schizophrenia and other psychotic disorders.

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Description of the Psychopharmacological Medication Agent

Aripiprazole is psychotropic medication. Aripiprazole is marketed in the U.S. under the brand name Abilify. Abilify is FDA-approved for schizophrenic disorders and acute manic episodes of bipolar disorder (Gettu & Saadabadi, 2022). It is available in tablet form and administered peroral.

Figure 1: Abilify Tablets

Valid and Reliable Research on Non-FDA Uses

Abilify is used off-label in the adjunctive treatment of comorbid psychotic and substance abuse disorders. It is also used to treat psychosis and agitation related to dementia (Crosby et al., 2021). In Parkinson’s, this drug treats delirium and ataxia.

Drug Classification

Aripiprazole is an antipsychotic medication.

The Medication Mechanism of Action

Aripiprazole is a partial D2 and 5-HT1 agonist and an antagonist at 5-HT 2a receptors. It stabilizes dopamine and serotonin within the frontal cortex, ventral tegmental areas, and the nucleus accumbens. In addition, it is a functional antagonist in the mesolimbic pathway where dopamine concentrations are high.

Figure 2: The mechanism of action of Abilify

Pharmacokinetics

Abilify tablets are administered orally, with or without food. Also, injectable forms are available for the management of acute symptoms. It is metabolized in the liver by the CYP3A4 metabolizing system and excreted in the feces.

Pharmacodynamics

Abilify is a partial agonist at dopamine and serotonin receptors. It also has an antagonistic effect on serotonin 2A receptors.

Appropriate Dosing, Administration Route, and Considerations for Dosing Alterations

The recommended adult dose for Abilify tablets is 10-15 mg once daily, orally. It can be taken with or without food.

Considerations of Use and Dosing In Specific Specialty Populations

Abilify is not recommended for use by persons below 15 years of age. Lower starting doses are required for persons aged 65 and above (Coustals et al., 2021). Its use is not recommended in pregnancy. Close supervision is necessary when this medication is given to persons with suicidal tendencies or ideation.

Half-Life Definition, Its Importance, and the Half-Life of Aripiprazole

Half-life is the time taken for the concentration of a drug to reduce to half. The half-life of aripiprazole is 75 hours. Half-life is crucial as it determines the dosing frequency.

Side Effects/Adverse Reaction Potentials

Extrapyramidal side effects may be apparent with aripiprazole use. These include akathisia, tardive dyskinesia, Parkinson-like symptoms of resting tremors, and acute dystonia. Other side effects include weight gain, hypercholesterolemia, hyperprolactinemia, glucose dysregulation, somnolence, nausea and vomiting, lightheadedness, and SIADH (Cuomo et al., 2019). Other rare side effects are jaundice and seizures.

Contraindications for Use

Aripiprazole is contraindicated in known hypersensitivity. This drug is metabolized in the liver by the CYP3A4 microsomal enzymes. Therefore, it can interact with other drugs metabolized by this enzyme system.

Overdose Considerations

There is no known antidote for aripiprazole overdose. Management of aripiprazole overdose focuses on supportive therapy for symptom relief. Early charcoal administration can help reduce the amount of the drug absorbed.

Diagnostics and Labs Monitoring

Baseline measurement of blood pressure, liver function, blood glucose, and electrolytes is necessitated before initiation of aripiprazole. A complete blood count is recommended in patients with preexisting leukopenia.

Comorbidities Considerations

Aripiprazole causes glucose derangements and may worsen diabetic symptoms. It can also worsen dyslipidemic symptoms. Patients with hypertension, renal disease, and hepatic disease taking aripiprazole should be monitored closely.

Legal and Ethical Considerations

Aripiprazole is a prescription-only medication. It should be given to patients with valid prescriptions only. Pharmacists and nurses should provide it judiciously to eligible patients to uphold the ethical obligation of doing good to the patients. Pharmacists should also check for drug interactions and verify dosing for patients on aripiprazole.

Pertinent Patient Education Considerations

Patients should be advised to eat healthily and exercise regularly when on aripiprazole due to concerns about weight gain. The patient should be educated on the side effects of this medication. They should be encouraged to maintain open communication with their prescribers to notify them of side effects that ensue with therapy.

References

Coustals, N., Ménard, M., & Cohen, D. (2021). Aripiprazole in Children and Adolescents. Journal Of Child And Adolescent Psychopharmacology, 31(1), 4-32. https://doi.org/10.1089/cap.2020.0014

Crosby, L., Kalanidhi, S., Bonilla, A., Subramanian, A., Ballon, J., & Bonilla, H. (2021). Off-Label Use Of Aripiprazole Shows Promise As A Treatment For Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Retrospective Study Of 101 Patients Treated With A Low Dose Of Aripiprazole. Journal Of Translational Medicine, 19(1). https://doi.org/10.1186/s12967-021-02721-9

Cuomo, A., Beccarini Crescenzi, B., Goracci, A., Bolognesi, S., Giordano, N., & Rossi, R. et al. (2019). Drug Safety Evaluation Of Aripiprazole In Bipolar Disorder. Expert Opinion On Drug Safety, 18(6), 455-463. https://doi.org/10.1080/14740338.2019.1617847

Gettu, N., & Saadabadi, A. (2022). Aripiprazole. Ncbi.nlm.nih.gov. Retrieved 24 September 2022, from https://www.ncbi.nlm.nih.gov/books/NBK547739/.

Hany, M., Rehman, B., Azhar, Y., & Chapman, J. (2022). Schizophrenia. Ncbi.nlm.nih.gov. Retrieved 24 September 2022, from https://www.ncbi.nlm.nih.gov/books/NBK539864/.

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Psychosis and schizophrenia significantly impact the brain’s normal processes, which interfere with the ability to think clearly. When symptoms of these disorders are uncontrolled, patients may struggle to function in daily life. However, patients often thrive when adequately diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, you will develop a study guide for an assigned psychotropic agent for treating patients with Schizophrenia Spectrum and Other Psychotic Disorders. You will share your study guide with your colleagues. These study guides will be a powerful tool in preparing for your course and PMHNP certification exam.

To prepare for this Assignment:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the treatment of patients with Schizophrenia Spectrum and Other Psychotic Disorders.
Research your assigned psychotropic medication agent using the Walden Library. Then, develop an organizational scheme for the vital information about the medication.
Review Learning Resource: Utah State University. (n.d.). Creating study guides. https://www.usu.edu/academic-support/test/creating_study_guides
The Assignment
Create a study guide for your assigned psychotropic medication agents. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the FDA-approved and Evidenced-Based Clinical Practice Guidelines Research but also supported by at least three other scholarly resources.

Areas of importance you should address, but are not limited to, are:

Title page
Description of the Psychopharmacological medication agent, including brand and generic names and appropriate FDA indication uses
Any supporting, valid, and reliable research for non-FDA uses
Drug classification
The medication mechanism of action
The medication pharmacokinetics
The medication pharmacodynamics
Mechanism of Action
Appropriate dosing, administration route, and any considerations for dosing alterations
Considerations of use and dosing in specific specialty populations to consider children, adolescents, elderly, pregnancy, suicidal behaviors, etc.
Definition of Half-life, why half-life is essential, and the half-life for your assigned medication
Side effects/adverse reaction potentials
Contraindications for use include significant drug-to-drug interactions
Overdose Considerations
Diagnostics and lab monitoring
Comorbidities considerations
Legal and ethical considerations
Pertinent patient education considerations
Reference Page
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your reasoning, it will not count toward the resource requirement. It would be best if you were utilizing the primary and secondary literature.