Middle-Aged Caucasian Man with Anxiety Essay Sample
Decision One
Zoloft 50mg po Daily
Of the three medications (Zoloft 50mg po daily, Imipramine 25 mg po BID and Buspirone 10 mg po DIB), I chose to begin Zoloft 50 mg daily.
Justification
To start with, Imipramine would be undesirable because it causes daytime drowsiness which would interfere with the patient’s occupation. On the same note, the drug would be detrimental at this level as it is an antidepressant that is used to treat major depression. Buspirone 10 mg po BID, on the other hand, was not appropriate because it may take long before the patient begins to feel better and is not alcohol friendly (Calhoun & Tedeschi, 2014).
The action mechanism for Zoloft 50mg characteristically defines the selective serotonin re-uptake inhibitors (SSRIs) with the capacity to link with the serotonin transporter. This drug works by reinstating the balance on the serotonin level (Buszewicz et al., 2017). The treatment normally undergoes a broad first-pass metabolism where the initial pathway of this metabolism is N-demethylation. According to Devane et al. (2016), the drug has a plasma end termination of between 62 and 104 hours which is recommendable. The 50mg dosage was chosen based on the weight of the client which would enhance absorption rate of the medication.
Expectations
First, it was expected that the drug would trigger reduction in panic attacks (Kirkham at al., 2016). On the same note, since the medication also increases the patient’s appetite, additional gain in weight was anticipated.
Deviation
There was no significant difference between the expected results and the achievement after four weeks of medication. The tightness of the chest and the shortness of breath declined remarkably. In addition, the patient also reported a relative period of declined worries about work in the last one week. Upon evaluation, it was confirmed that HAM-A score had dropped to 18 indicating a partial response to the problem.
Decision Two
Given the positive outcomes reported by the patient so far, I chose to increase the daily oral dosage of Zoloft from 50 mg to 75mg.
Justification
This action was meant to improve the recovery period and to improve the HAM-A score. Increasing the dosage to 100mg was unnecessary at this level as this would have resulted to undesirable side effects. On the same note, failure to increase Zoloft’s dose would have derailed the recovery process.
Expectations
After increasing the dosage of Zoloft, it was expected that the patient would recover fully from the panic attacks and anxiety. In addition, with a higher dose of Zoloft, it was anticipated that the recovery period would be shorter than with 50mg dosage.
Deviation
The patient came back after four weeks and upon examination, it appeared that the increased dosage worked remarkably. According to the client, anxiety symptoms improved significantly. It was interesting to note the HAM-A score was at 10. This was a further 61% reduction in the symptoms but the problem was not fully solved. Perhaps, there was need to consider other factors beside drugs.
Decision Three
I choose to educate the client regarding diet/weight loss and continue the same drug/dose.
Justification
Maintaining the current dose alone was not enough because the client’s full recovery to a certain extent depended on other measures such as weight loss. Increasing Zoloft’s dose to 100mg was unnecessary as this could have triggered undesirable side effects (Taylor, 2011). A combination of the current dose and education on the need to reduce weight was necessary especially considering the patient was overweight.
Expectations
The patient was expected to recover fully by the end of the prescription.
Deviation
No notable differences between expectations and the outcomes of this decision.
Ethical Considerations There are various ethical considerations in the treatment plan and communication with the client. First, the treatment of anxiety requires a medical practitioner to make decisions based on strict professionalism and rationales and reassessing the patient more often to ensure that there are no severe consequences of the medica…………………………..
Middle-Aged Caucasian Man with Anxiety Essay Sample
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