N521 Advanced Pharmacology Assignment Three
Advanced Pharmacology
Assignment 3
L. P., age 23, is a Hispanic woman who graduated from college last year. She reports to the CNP in her local community mental health center. She began working as an accountant 1 month after graduating. Approximately 2 months ago, she moved into a two-bedroom apartment with another woman who works at the same accounting firm. She states that her roommate recommended that she see a doctor to find out if she has anemia or “some sort of fatigue syndrome.” She states that she has felt “restless” and “on edge” for most of the past 9 months. She becomes easily fatigued and irritable and has difficulty concentrating and falling asleep. She states that sometimes her mind “just goes blank,” and she is worried that her work performance is no longer excellent. She reports that all her life she had good grades in school and was very successful in everything she attempted. Although she has been “a worrier from the day I was born,” now she worries more than she ever has and feels nervous “all the time.” L. P. reports that she has a good relationship with her boyfriend but they do not get to see each other very often because he is attending graduate school 100 miles away. She reports having a satisfying sexual relationship with him. She denies having any problems with relationships with her parents, roommate, or peers. She denies having any financial worries unless she is fired from her job for poor work performance. She reports that she has always been healthy and has taken good care of herself. The only medication she takes is birth control pills, which she has taken for the past 4 years without any adverse effects.
In a paper not to exceed six pages, excluding title and reference pages, submit your answers to the following in an MS Word document:
- What is L. P.’s likely diagnosis?
- List specific pharmacotherapeutic treatment goals for L. P.
- Should the CNP order any labs for L. P. at this time? Why?
- What drug therapy would the CNP likely prescribe? Why?
- What are the parameters for monitoring the success of the therapy?
- Describe specific patient monitoring based on the prescribed therapy.
- List one or two adverse reactions for the selected agent that would cause the CNP to change therapy.
- L. P. returns to see the CNP after six weeks, complaining of still feeling anxious and had heard of a medication called Klonopin that she would like to try; how should the CNP respond to her request?
- What health promotion activities should be recommended for this patient?
- What is L. P.’s long-term prognosis?
SAMPLE ANSWER
The following case study involves a 23-year-old Hispanic woman, LP, who’s a recent college graduate working as an accountant. Two months ago, LP moved into a two-bedroom apartment with another woman that works at the same accounting firm. LP visits her community’s mental health center for an evaluation because her roommate advised her to see a doctor for “anemia or some sort of fatigue syndrome”. LP states feeling “restless” and “on edge” for the past 9 months. Furthermore, she reports fatigue and irritability; difficulty concentrating and falling asleep; nervousness; and that sometimes her mind “just goes blank”. These symptoms have caused LP to worry about her job performance and has fears of getting fired. She reports that throughout her life she’s had good grades and has been successful at everything she’s attempted. She feels she has a healthy and sexually satisfying relationship with her boyfriend but they seldomly see each other as he attends graduate school a 100 miles away. She denies financial problems and has no relationship issues with her parents, roommate, or peers. She reports she’s always been healthy and has taken good care of herself. LP reports taking no medication other than birth control pills, which she has taken for four years without adverse effects.
Diagnosis
LP’s symptoms of restlessness, fatigue, irritability, difficulty concentrating, difficulty falling asleep, feelings of worrisome, nervousness, and forgetfulness during the past 9 months are indicative of generalized anxiety disorder (GAD). GAD is “characterized by at least six months of persistent and excessive anxiety and worry” (Arcangelo, Peterson, Wilbur, and Reinhold, 2017, p. 702). Four of LP’s symptoms meet the criteria for diagnosing major depressive disorder, however; to diagnose major depressive disorder there must be five or more symptoms present for a two-week period. Symptoms must also include a depressed mood most of the day and/or a decreased interest in normal activities according the 2013 version of the American Psychiatric Associations publication, The Diagnostic and Statistical Manual of Mental Disorders 5 (as cited by Arcangelo & Peterson, 2017).
Pharmacotherapeutic Treatment Goals for GAD
Long-term treatment goals for GAD are complete resolution of anxiety symptoms and improvement of the overall functioning and quality of life. Pharmacologic treatment should improve self-control without daytime drowsiness, physical dependence, or psychological dependence. It is important to recognize that pharmacotherapy cannot cure an anxiety disorder but can alleviate or minimize its symptoms.
Leave a Reply
Want to join the discussion?Feel free to contribute!