Korean woman with bipolar I disorder.

Examine Case Study in uploaded file to on Korean woman with bipolar I disorder.
Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

• At each decision point stop to complete the following:
o Decision #1
? Which decision did you select? START RISPERDAL 1 MG ORALLY BID.
? Why did you select this decision? Support your response with evidence and references.
? What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
? Explain any difference between what you expected to achieve with Decision #1 and the results (client returns in 4 weeks with her mother looking lethargic and sedated. Mother states that she has been like this since a week after the first visit). Why were they different?
o Decision #2- DECREASE RISPERDAL 1 MG HS.
? Why did you select this decision? Support your response with evidence and references
? What were you hoping to achieve by making this decision? Support your response with evidence and references.
? Explain any difference between what you expected to achieve with Decision #2 and the results of the decision (client returns in 4 weeks less sedated, less lethargic and shows symptom improvement. Young Mania rating scale decreased from 22-16 {less than 25% decrease in symptoms}). Why were they different?
o Decision #3- CHANGE TO LATUDA 40 MG ORALLY DAILY.
? Why did you select this decision? Support your response with evidence and references.
? What were you hoping to achieve by making this decision? Support your response with evidence and references.
? Explain any difference between what you expected to achieve with Decision #3 and the results of the decision (It would be wise to allow the client to remain at the same dose and reassess in 4 weeks. Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may have slower clearance of Risperdal from her system, which may have resulted in higher than normal levels of Risperdal in the blood, which in turn resulted in sedation.). Why were they different?
• Also include how ethical considerations might impact your treatment plan and communication with clients.