Your Topic: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER
Your Topic: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER
Your Topic: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER
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**********1-In one paragraph with two references, suggest additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD. In addition, suggest different treatment options you would suggest to treat a patient with GAD with the below scenario**********
A Caucasian 35-year-old teacher with two children was diagnosed with GAD. The patient often complained of feeling “Shortness of breath (SOB), a feeling of impending doom, and a tightening of the chest all made her feel like she was having a heart attack and wanted to die. We had to rule out Myocardial Infarction (MI) due to the complaints of chest tightness and SOB, thus an EKG was done to do so. Constant sinus rhythm and tachycardia were detected on the ECG. The patient claimed to be in good health, did not have any medical history, and had a supportive husband. According to the patient, she hasn’t been able to return to her “normal peaceful and joyful self” since her best friend passed away from cancer a few years ago. Reports consuming “half a bottle” or less of wine many times each week to “quiet down her anxieties. The patient scored a 32 on the Hamilton Anxiety Rating Scale, classifying her as having “moderate to severe” anxiety. Given that the patient drinks alcohol virtually every day, it is crucial that the doctor prescribes drugs that are safe for people who do the same. In the first instance, I would turn to buspirone 10mg taken orally twice daily. Buspirone is safe to use in patients who use drugs and alcohol because it is neither addictive nor sedative (Rosenthal &Burchum, 2021). According to Rosenthal & Burchum (2021), it is clear that buspirone has a delayed therapeutic reaction. The first response to the medicine is anticipated to occur in about a week after the start of treatment, and it may take up to four weeks to reach the predicted therapeutic level. Buspirone dosage might be increased to “Buspirone 10mg by mouth three times a day” if the patient is still exhibiting increasing anxiety symptoms after four weeks but is still scoring in the “moderate” zone of the HARS. Buspirone has a lower risk of suicide and a safe daily dose of up to 375 mg. Mild side effects include nausea, vomiting, miosis, and dizziness (Rosenthal & Burchum, 2021). After a dose increase of four weeks, the medicine would be reassessed. If the patient’s anxiety symptoms do not improve and their HARS score remains in the mild range, I would stop giving them buspirone. When the patient has been taking buspirone for more than four weeks and has reached the buspirone peak concentration, switching to a selective serotonin reuptake inhibitor is advised (SSRI). As a result, I would begin giving the patient 50 mg of Zoloft daily by mouth. SSRIs are typically given to treat depression, however, research suggests that they can also be used to treat anxiety symptoms safely, with a demonstrable reduction in anxiety symptoms (Rosenthal& Burchum, 2021).
**********2-In one paragraph with two references, suggest additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD, BUT NOW HAVING Serotonin syndrome. In addition, suggest different treatment options you would suggest to treat this patient.***********
A patient was brought in because according to his wife, he was confused and agitated. When assessed the patient was diaphoretic and hypertensive. After getting a medical history from his wife we found out that a few weeks ago he had a work injury and was prescribed Tramadol and instructed to take it but stop taking his Prozac which he did while he was taking his pain medication. A couple of days before his episode he began taking his Prozac again and was still taking his Tramadol which is when she saw some changes. He was diagnosed with Serotonin syndrome, according to Chu & Wadhwa, 2023, this is a life-threatening consequence of increased serotonergic activity and results from combining multiple medications that increase serotonin levels. As for his plan of care, there is no definitive treatment besides discontinuing the offending agent which means stopping his Tramadol and Prozac. Supportive measures and in this case we started him on IV fluids to replace what was lost due to his diaphoresis, stabilize his vitals such as control his tachycardia and hypertension, stabilize his oxygen levels, provide cardiac monitoring, and sedate with benzodiazepines for any agitation. In the article, Chu & Wadhwa, 2023, explain that Cyproheptadine, a serotonin antagonist, has shown success in cases where the patient did not respond to initial treatment but we did not have to offer this to my patient
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