Need ONE Response Per Each Discussion Total 2 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion
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week14replies.docxLisleinys Valdes
5 hours ago, at 6:44 AM
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Generalized Anxiety Disorder
1. List specific treatment goals for L.P.
The specific treatment goals for L.P is to ease decision making, reduce being helpless, reduce the continuousness and strength of anxiety so that daily work is not affected, to change unusual behaviors, to develop and maintain good relationship and finally increase the understanding of anxiety feelings.
2. What drug therapy would you prescribe? Why?
The drug therapy prescription for L.P is sertraline (Zoloft), a selective serotonin reuptake inhibitors used as an antidepressant(Mahase, 2019).The drug is mainly used to treat persistent depression and it works by creasing serotonin in the brain. Thisdrug is in tablet form of 50mg and should be taken orally(Strawn et al., 2018). L.P should start with low dose of one tablet daily and increase the dosage slowly in every week as the symptoms improves. The medication should be taken for 4 to 6months.
3. What are the parameters for monitoring the success of the therapy?
The parameters for monitoring the success of the therapy include the following: reduced fatigue which indicates the success of therapy, increased concentration and improved work performance. Finally, the patient will start developing good relationship with people and stop being irritable. All this will show how effective and successful the therapy given to the patient is.
4. Describe specific patient monitoring based on the prescribed therapy.
The specific patient factor to be monitored is fatigue. Frequent fatigue will make the life of the patient very difficult. Fatigue will affect the work performance of the patient and reduce the concentration. Being consistently monitored will help the patient improve and regain his strength.
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
The adverse reactions that can lead to the change of the use ofsertraline (Zoloft) as medication includes the following:diarrhea, sleeping a lot and increased fatigue (Strawn et al., 2018). If the patient experiences these reactions, the medication prescribed should be changed immediately to a better one.
6. What would be the choice for second-line therapy?
The second line therapy is fluvoxamine which is also a selective serotonin reuptake inhibitors used to treat anxiety (Gosmann et al., 2021). The drug is in tablet form and should be taken orally. The starting dose is one tablet of 50mg once a day at bedtime and the dose will be increased after 1 week to two tablets once a day also at bedtime. The dose should be taken for 4 to 6 months.
References
Gosmann, N. P., Costa, M. D. A., Jaeger, M. D. B., Motta, L. S., Frozi, J., Spanemberg, L., ... & Salum, G. A. (2021). Selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors for anxiety, obsessive-compulsive, and stress disorders: A 3-level network meta-analysis. PLoS medicine, 18(6), e1003664.
Mahase, E. (2019). Sertraline is better at reducing anxiety than depressive symptoms. BMJ: British Medical Journal (Online), 366.
Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert opinion on pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966
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Lucia Reyes
8 hours ago, at 3:41 AM
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Specific Treatment Goals
Generalized anxiety disorder (GAD) is characterized by unwarranted and exaggerated concern and worry about daily life events for no apparent reason. The specific treatment goal for the client would be to reduce the intensity and frequency of the anxiety to ensure it does not impair her daily functioning.
Drug Therapy
I would prescribe Escitalopram 10 mg once a day orally with a potential upward titration to 20 mg one time a day after one week of therapy initiation depending on the client’s response, but the dosage should be maintained as low as possible. Serotonin-Selective Reuptake Inhibitors (SSRIs) are the recommended first-line treatment for GAD because of their efficacy and tolerability, and Escitalopram belongs to this class of medication (DeMartini, Patel & Fancher, 2019).
Therapy Monitoring
Upon Escitalopram therapy initiation, the client would be monitored for treatment response, tolerability, adherence, safety and the possibility of suicidal ideation after one week and every two weeks after that. The patient should specifically be monitored for any increase in suicidal ideation or thoughts and self-destructive behavior, which is synonymous with Escitalopram therapy (DeMartini et al., 2019). The drug has a black box warning for an increased suicide risk as per the 2018 FDA drug label requirements.
Adverse Reactions
A reported increase in suicidal ideation or thoughts and self-destructive behavior should inform change of therapy. Other adverse reactions that should necessitate a change of therapy include visual problems, seizures and abnormal bleeding.
Second-Line Therapy
For the second-line therapy for this client, I would prescribe Alprazolam because of its demonstrated efficacy in the treatment of GAD (Gomez, Barthel & Hofmann, 2018). However, I would only prescribe it for a short duration of time because of its associated side effects, withdrawal issues and potential for dependence.
References
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized anxiety disorder. Annals of internal medicine, 170(7), ITC49-ITC64.
Gomez, A. F., Barthel, A. L., & Hofmann, S. G. (2018). Comparing the efficacy of benzodiazepines and serotonergic anti-depressants for adults with generalized anxiety disorder: a meta-analytic review. Expert opinion on pharmacotherapy, 19(8), 883-894.
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