The H&P I had presented on was based on a patient diagnosed with schizoaffective disorder who was being treated with a long-acting antipsychotic monthly injection. The patient had been responding well to the medication; however, they had recently been diagnosed with end-stage renal disease which called their medication regimen into question. My journal article focused on when to adjust the dosing of psychotropics in patients with renal impairment. It went through the different classes of psychotropics and discussed studies and evidence that demonstrated whether a certain class of medication needed to be adjusted depending on the severity of renal impairment. For example, the 1st generation anti-psychotics don’t need adjustments because most of them are excreted in urine as inactive metabolites. As far as 2nd generation antipsychotics go, most undergo extensive hepatic metabolism before excretion making them safe to use in patients with renal impairment. There were also recommendations for anti-depressants, mood stabilizers, and MAOIs. In conclusion, I found that the long-acting IM injection the patient had been on is contraindicated with the patient’s condition and required an adjustment to the treatment they were receiving.
