A Middle-Aged Caucasian Man With Anxiety.

Posted: January 1st, 2023

A Middle-Aged Caucasian Man With Anxiety.

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. At each decision point stop to complete the following: Decision #1 Which decision did you select?A Middle-Aged Caucasian Man With Anxiety.

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Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Decision #2 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? Decision #3 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.A Middle-Aged Caucasian Man With Anxiety. 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. Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.A Middle-Aged Caucasian Man With Anxiety.

A Middle-Aged Caucasian Man with Anxiety
Introduction
Anxiety disorders include a group of mental disorders typified by significant feelings of fear and anxiety. anxiety disorders cause significant distress that interferes with the ability of the individual to carry on with the normal life (Sadock et al., 2014). In this case study, a 46-year-old man presented complaining of breath shortness, chest tightness, and a feeling of impending doom. Myocardial infarction was ruled out as the cause of the symptoms because the findings of ER and ECK were within the normal range. However, the client’s score in the Hamilton Anxiety Rating Scale (HAM-A) was 26 and as a result, this confirmed the diagnosis as generalized anxiety disorder. This assignment will present three decisions regarding the appropriate treatments to prescribe to the client. Additionally, any ethical issues that could affect the treatment of this client will be discussed.A Middle-Aged Caucasian Man With Anxiety.
Decision Point One
The selected treatment for the client is Zoloft 50 mg. Zoloft was chosen for this client because it is a serotonin selective reuptake inhibitor that increases the amount of serotonin within the brain and therefore regulates the mood and thus improves the anxiety symptoms (Allgulander et al., 2015). GAD is characterized by long periods of stress which depletes the amount of serotonin in the brain and this explains the efficacy of Zoloft in treating GAD. Moreover, studies have demonstrated the efficacy of Zoloft in the treatment of GAD (Allgulander et al., 2015.
Selecting Zoloft expected that the symptoms of GAD manifested by the client such as shortness of breath, chest tightness and excessively worrying about work would significantly improve. This is due to the efficacy of Zoloft in treating psychic and somatic symptoms in people with GAD (Allgulander et al., 2015). Zoloft also has a good safety profile and thus it was expected that the client would tolerate the medication and report minimal or no side effects.A Middle-Aged Caucasian Man With Anxiety.
After four weeks of taking Zoloft, the client report symptom improvement as indicated by the remission of chest tightness and shortness of breath. Moreover, the client had stopped worrying about his job and as per the HAM-A score (from 26 to 18),the client manifested partial response to the treatment. this is attributable to the efficacy of Zoloft in treating GAD(Allgulander et al., 2015).
Decision Point Two
The second decision was increasing the Zoloft dose to 75 mg for the client. This decision was chosen in order to augment the response of the client to treatment because with the dose of Zoloft 50 mg the client was manifesting partial response. Therefore, increasing the dose from 50 mg to 75 mg is expected to increase the level of serotonin in the brain leading to further symptom improvement(Allgulander et al, 2015). Moreover, evidence recommends increasing the dose of SSRIs in case the patient shows a partial response or is not responsive to the initial dose (Bandelow et al, 2017). Secondly, the client did not report side effects with Zoloft 50 mg and thus it is hoped that he would tolerate the increased dose.A Middle-Aged Caucasian Man With Anxiety.
By selecting the dose to increase the dose to 75 mg, the expectation is that the GAD symptoms would continue improving and this would be indicating by a significantly reduced HAM-A score. This is due to the ability of the increased dose to avail more serotonin in the brain and hence leading to increased symptom improvement (Allgulander et al, 2015).
As was expected, the client continued to show symptom improvement as indicated by further reduction of HAM-A score to 10, showing 61 percent symptom reduction. This is attributable to the increased amount of serotonin in the brain, with the increased dose and hence increased efficacy (Stahl, 2014).
Decision Point Three
The last decision was maintaining the current dose of Zoloft at 75 mg. This decision was selected since the client manifests significant symptom improvement with 75 mg. Gautam et al (2017) explain that SSRIs should be started at a lower dose and then titrated upwards depending on the response and patient’s ability to tolerate the medication. The client indicated satisfactory response and did not report any side effects and therefore justifying maintaining the current dose.
Selecting the decision to maintain the current dose of Zoloft 75 mg hoped that the client would continue manifesting symptom reduction and eventually achieve complete symptom remission.A Middle-Aged Caucasian Man With Anxiety.
Ethical Considerations
Ethical considerations that could influence the treatment of this client include autonomy and informed consent. It is therefore important for the PMHNP to seek informed consent from the client prior to beginning treatment. The PMHNP shouldexplain to the client about the available treatment options, including their side effects (Murgic et al, 2015). For autonomy, the PMHNP should respect the decision of the client to either accept or refuse the prescribed treatment regimen (Murgic et al, 2015).A Middle-Aged Caucasian Man With Anxiety.
Conclusion
The first decision that was chosen for this client is to start Zoloft 50 mg. This decision was chosen because it is an SSRI that has been demonstrated to be effective in treating GAD. The client showed partial response with Zoloft 50 mg and thus the second decision is to increase the dose of Zoloft to 75 mg. The client tolerated the increased dose and continued to showsignificant symptom reduction and thus the third decision was to maintain the Zoloft dose of 75mg. The applicable ethical aspects include informed consent and autonomy.A Middle-Aged Caucasian Man With Anxiety.