Introduction:
The case study is about a middle-aged Caucasian man who is experiencing anxiety symptoms, including shortness of breath, palpitations, and sweating. The patient has no significant medical history and is not taking any medication. Upon further assessment, it was determined that the patient meets the diagnostic criteria for panic disorder with agoraphobia. In this assignment, we will be discussing the treatment options for the patient and how to manage the ethical considerations while developing the treatment plan.
Factors affecting medication prescription:
There are various factors that can impact the prescription of medication for the patient, including age, weight, comorbidities, and pharmacokinetic and pharmacodynamic processes.
Decision #1:
The first decision is to prescribe a selective serotonin reuptake inhibitor (SSRI) to the patient. The recommended SSRI for panic disorder is sertraline, which has been shown to be effective in reducing the symptoms of panic disorder.
Reasons for selecting this decision:
Sertraline is a widely used and effective medication for the treatment of panic disorder with agoraphobia. It has a low potential for drug interactions and has a favorable side-effect profile, making it a good choice for the patient.
Reasons for not selecting other options:
The other options presented were benzodiazepines and beta-blockers. Benzodiazepines have a high potential for abuse and dependence, making them unsuitable for long-term use. Beta-blockers are effective in reducing physical symptoms such as palpitations and tremors, but they do not address the underlying anxiety disorder.
Hoping to achieve:
The goal of prescribing sertraline is to reduce the patient’s symptoms of panic disorder, including panic attacks and agoraphobia. The medication will help the patient manage his anxiety and function better in daily life.
Ethical considerations:
While prescribing medication, ethical considerations need to be taken into account. Informed consent should be obtained from the patient before starting the medication, and the potential side effects of the medication should be discussed. The patient’s autonomy and right to refuse medication should be respected.
Decision #2:
The second decision is to increase the dosage of sertraline from 25mg to 50mg per day.
Reasons for selecting this decision:
Increasing the dosage of sertraline is a common practice when the initial dosage is not effective in reducing the symptoms. It has been shown that sertraline at higher doses can be more effective in treating panic disorder.
Reasons for not selecting other options:
The other options presented were to switch to a different SSRI or to add a benzodiazepine to the treatment plan. Switching to a different SSRI may not be effective as the patient is already taking a medication that is effective for panic disorder. Adding a benzodiazepine can lead to dependence and may not be a long-term solution.
Hoping to achieve:
The goal of increasing the dosage of sertraline is to improve the patient’s symptoms and reduce the frequency and intensity of panic attacks.
Ethical considerations:
Before increasing the dosage of sertraline, the patient should be informed about the potential side effects and benefits of the medication. The patient’s preferences and values should be taken into account, and informed consent should be obtained.
Decision #3:
The third decision is to refer the patient to cognitive-behavioral therapy (CBT) in addition to continuing the medication.
Reasons for selecting this decision:
CBT has been shown to be effective in treating panic disorder and can provide long-term benefits. Combining medication with CBT can lead to better outcomes and may reduce the need for long-term medication use.
Reasons for not selecting other options:
The other options presented were to continue with medication alone or to switch to a different medication. Continuing with
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