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INTRODUCTION

Paranoid schizophrenia is the most common type of schizophrenia in most parts of the world. The clinical picture is dominated by relatively stable, often paranoid, delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Disturbances of affect , volition and speech, and catatonic symptoms, are not prominent. Patients who have paranoid schizophrenia that has thought disorder may be obvious in acute states, but if so it does not prevent the typical delusions or hallucinations from being described clearly. Affect is usually less blunted than in other varieties of schizophrenia, but a minor degree of incongruity is common, as are mood disturbances such as irritability, sudden anger, fearfulness, and suspicion . Negative symptoms such as blunting of affect and impaired volition are often present but do not dominate the clinical picture. The course of paranoid schizophrenia may be episodic , with partial or complete remissions, or chronic. In chronic cases, the florid symptoms persist over years and It is difficult to distinguish discreet episodes. The onset tends to be later than in the hebephrenic and catatonic forms.

Personal Data: Name of Patient: Mr J.E Age: 46 y.o Gender: M Address: Caloocan City Civil Status: Single Nationality: Filipino Religion: Roman Catholic Birthday: Date Admitted: Admitting Diagnosis: Paranoid schizophrenia

Past Health History: The patient used to take prohibited drugs. Tried to smoke and drink liquors. The patient was rehabilitated when he was 17 years old.

DRUG STUDY Brand Name: Risperdal Pregnancy Category C Drug classes: Antipsychotic, Benzisoxazole Therapeutic actions Mechanism of action not fully understood: blocks dopamine and serotonin receptors in the brain, depresses the RAS; anticholinergic, antihistaminic, and alpha-adrenergic blocking activity may contribute to some of its therapeutic and adverse actions. Indications Treatment of schizophrenia Delaying relapse in long-term treatment of schizophrenia

Unlabeled uses: bipolar disorder; treatment of patients with dementia-related psychotic symptoms Contraindications Contraindicated withhypersensitivity to risperidone, lactation.

Use cautiously with cardiovascular disease, pregnancy, renal or hepatic impairment, hypotension. Adverse effects Insomnia, anxiety, agitation, headache, somnolence, aggression, dizziness, tardive dyskinesias, Orthostatic hypotension,arrhythmias, Rash, dry skin, seborrhea, photosensitivity, Nausea, vomiting, constipation, abdominal discomfort, dry mouth, increased saliva, Rhinitis, coughing, sinusitis, pharyngitis, dyspnea, Chest pain,arthralgia, back pain, fever, neuroleptic malignant syndrome Drug Interactions: Increased therapeutic and toxic effects with clozapine

Decreased therapeutic effect with carbamazepine Decreased effectiveness of levodopa

Nursing considerations Maintain seizure precautions, especially when initiating therapy and increasing dosage. Mix oral solution with 34 oz of water, coffee, orange juice, or low-fat milk. Do not mix with cola or tea. Monitor T. If fever occurs, rule out underlying infection, and consult physician for appropriate comfort measures. Advise patient to use contraception during drug therapy. Follow guidelines for discontinuation or reinstitution of the drug carefully.