caucasian patient with generalized anxiety disorder

Order Description

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure

to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

DECISION 1 OPTIONS
Begin Zoloft 50mg orally daily.
Begin Impipramine 25mg orally twice a day.
Begin Buspirone 10mg twice daily.

At each decision point stop to complete the following:

• My decision #1 (my first decision Zoloft 50mg by mouth daily)

o Which decision did you select?

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

o OUTCOME
Patient returns to the clinic in 4 weeks
Client says he has no chest tightness or shortness of breath
Clients says he noticed decreased worries over work in the past 4 to 5 days
HAM-A score dropped to 18 (partial response)

DECISION 2 options
Increase Zoloft dose to 75mg daily
Increase Zoloft to 100mg daily
No changes in drug/dose at this time

• My decision #2 (Increase Zoloft dose to 75mg daily)
o
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o
o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
o
o OUTCOME

Client returns to clinic in four weeks
Client reports further decrease in symptoms
HAM-A score decreased to 10. At this point continue current dose (61% reduction in symptom)

DECISION 3 OPTIONS
Maintain current dose
Increase current dose to 100mg daily
Add augmentation agent such as Buspirone (Buspar)

• My decision #3 (Maintain current dose)
o
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

OUTCOME OF DECISION 3

At this point, it may be appropriate to continue client on current dose. It is clear that the client is having a good response (greater 50% reduction in symptoms) and

the client is currently no experiencing any side effects, the current dose can be maintained for 12 weeks to evaluate full effect of drug. Increasing the dose now may

yield further decrease in symptoms but may increase risk of side effects.

YOUR JOB

Using at least 4 references provide rationales for each step of the decision tree. Following the steps provided in the rubric given.

Provide an overview of generalized anxiety disorder with references

Pharmacokinetics and pharmacodynamics of the chosen drug (Sertraline)

Also include how ethical considerations might impact your treatment plan and communication with clients. Include references.