Patient: "I got really angry" Folks: "Violent Episodes"

Aripiprazole 5mg/tab, 1/2 tab ODHS

Psyche Ward

Asking patient for chief complaint lets you know his/her insight of his condition

Patient: "Ginabaligya ako sng akon gnikanan" Folks: "naglain na sya"

Alcohol Use Disorder, Severe; Alcohol Withdrawal Syndrome; Alcohol-induced psychosis; T/c Cellulitis Bilateral Leg

1. Diazepam 5mg IVTT q4h--> q6h--> q8h to consume IV stocks then shift to oral--> 10mg/tab 1/2 tab q12h; 2. Vitt B complex 1 amp Deep IM OD x3days ANST; 3. Vit B complex 1 tab BID

CIWA= 2 (3/7/21)

CIWA >9, increase dose/frequency of diazepam

Patient: "Ginbuno ko ang robot" Folks: " Ginbuno ang iya nanay"

Schizophrenia; CeVD Infarct; BPH

1. Clozapine 100mg/tab, 1 tab BID; 2. Biperiden 2mg/tab 1 tab OD; 3. Olanzapine 10mg/tab 1 tab ODT, 1 dose at ER

Clozapine good for negative symptoms

Patient: "…" Folks: "Gaseizure sya"

Psychosis secondary to General Medical Condition; Seizure Disorder

1. Risperidone 2mg/tab, 1 tab ODHS; 2. Valproic Acid 500mg/tab 1 tab AM, 1 1/2 tab PM; 3. Clonazepam 2mg/tab, 1/4 tab for restlessnes/sleeplessness

EEEG at OPD basis

Valproic Acid may cause cardiac arrythmia (right bundle branch block)

Patient: "Indi ko mag-inom bulong" Folks: Gapanghaboy bato"

Bipolar 1 Mood Disorder with Psychotic Features (most recent episode: manic)

Olanzapine 10mg/tab 1/2 tab in AM and 1 tab HS; 2. Divalproex Na 500mg/tab 1 tab TID; 3. Lithium 450mg/tab 1 tab BID; 4. Paracetamol 500mg/tab 1 tab Q4H PRN

4 point restraint; Watch out for EPS; Plan to slowly decrease Divalproex and maintain on Lithium

Lithium 0.6-1.2 meq/L therapeutic range

Patient: "…" Folks: "Gahapo siya doc"

Bipolar 1 Mood Disorder with Psychotic Features; Encephalopathy, probably metabolic vs septic component; ARF type 2, probably secondary; CAP MR vs COPD in AE; COVID Suspect

Risperidone 2mg/tab 1/4 tab PRN; Intubated and on Norepinephrine

Meropenem can decrease seizure threshold

Ortho: " For depressed mood"

No Psychiatric Diagnosis at the moment; DM type 2 Insulin Requiring; DM foot s/p debridement

For psyche support; For Debridement

Reason for Referral: For continuity of care

Schizophrenia; Obstructive Jaundice sec to Choledocholithiasis in Cholangitis; Autoimmune Hemolytic Anemia- Resolving; BPH; s/p ERCP (3/3/2021)

Olanzapine 10mg/tab 1/2 tab ODHS

Olanzapine on hold for bradycardia temporarily

RFR: Episodes of restlessness and agitation

Delirium due to General Medical Condition; Meningoencephalitis considered probably TB vs Viral; Encephalopathy Multifactorial; Pneumonia; AKI on top of CKD

Risperidone 2mg/tab 1/2 tab ODHS

Delirium if with increased WBC

No Psychiatric Diagnosis at the moment S/p AKA, Left (3/3/2021)

For Psyche Support

Pedia Ward

Patient: Back Pain; RFR: for comanagement

Schizoaffective Disorder; Breast Cancer, Left Stage 3 t/c 4; S/p Mastectomy,Left (september 2019); Chemotherapy 8 cycles (Nov 2019-April 2020)

1. Sertraline 50mg/tab 1 tab OD; 2. Clonazepam 2mg/tab 1 tab PRN for sleeplessness

Still anxious, scared

Patient: "Ginsumbag ko ang espiyo" Folks: " Nagbalik naman doc ang ginabatyag niya"

1. Olanzapine 10mg/tab 1 tab ODHS 2. Clonazepam 2mg/tab, 1/4 tab PRN for sleeplessness

If with factors to develop metabolic syndrome, can switch to Risperidone

Patient: " Hiluan nila ako doc" Folks: "Gin bugbog niya tiyo niya"

1. Amisulpride 200mg/tab, 1 tab BID 2. Divalproex Na 500mg/tab 1 tab TID

Amisulpride: good for negative symptoms

Patient; " Hindi ako katulog" Folks: "Hindi siya katulog"

1. Diazepam 5mg/tab 1 tab Q12H 2. Vitamin B complex 1 tab BID 3. Vitamin B complex amp, 1 amp OD x 3 doses

Patient: "Kamo nagkuha kwarta ko!" Folks: "Ga.irritable siya"

1. Olanzapine 10mg/tab 1/2 tab AM, 1 tab HS; 2. Divalproex Na 500mg/tab 1 tab BID; 3. Clonazepam 2mg/tab 1/2 tab as STAT doses