The psychiatric patient

Abstract

A 59-year-old female with COPD presented for assessment prior to right total hip arthroplasty. She had a 30-year history of tobacco use but had recently quit. Past medical history was positive for mild sleep apnea, gastroesophageal reflux disease (GERD), hypertension, and cervical carcinoma for which she underwent a hysterectomy without incident. She had a longstanding diagnosis of bipolar disorder, which she indicated had been stable for 2 years. She reported two episodes of mania in the last 5 years, both of which required inpatient management, including brief courses of electroconvulsive therapy (ECT). She had no allergies. Current medications included tiotropium bromide 2.5 mg OD, fluticasone propionate/salmeterol 100 μg/50 μg BID, albuterol 100 μg PRN Q6H, lithium 600 mg BID, quetiapine 400 mg OD, and acetaminophen 500 mg QID.