ASSESSING AND TREATING PATIENT WITH SLEEP/ WAKE DISORDERS/ Treatment of Isomnia in a younger Adult.
Case Study: SUBJECTIVE: The patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but he is now having difficulty falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden death of his fiance.
The patient states this is affecting his ability to perform his job, which is a forklift operator at a chemical company. The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He said he has fallen asleep on the job due to a lack of sleep the night before.
The patient medical record from the previous physician state that he has opiate abuse, which began after he broke his ankle from a skiing accident and was prescribed hydrocodone/APAP(acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years.
The patient states recently he has been using alcohol to help him fall asleep, appropriately 4 beers prior to bed. The patient is alert and oriented to place, person, time, and events. He makes good eye contact and is dressed appropriately for the time of the year. He denied auditory/homicidal ideation and is future-oriented.
ASSIGNMENT INSTRUCTIONS ARE: Review the resources, including the medications, and reflect on the psycho pharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders.
The ASSIGNMENT: 5 PAGES. You are asked to make THREE decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. AT each decision point, you should evaluate all options before selecting your MEDICATION DECISION.
Make sure that you have researched each option and that you evaluate the decision that you have selected. Be sure to research using the primary literature. THE Medications are (1) Zolpidem 10mg PO daily at bedtime. (2) Trazodone 50mg PO at bedtime.(3) Hydroxyzine 50 mg PO daily at bedtime.
(1) Introduction to the case (1):
Briefly explain and summarize the case for this Assignment. Be sure to include the patient-specific factors that may impact your decision-making when prescribing medication for this patient.
DECISION 1: ( page 1):
(a) Which Medication decision did you select.
(b)Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
(c) Why did you not select the other two medication options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
(d) What were you hoping to achieve by making this decision? Support your response with evidence and references to the learning resources( including the primary literature).
(e) Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
DECISION 2 (1 Page): What medication from the THREE medications above will you give or continue to give or increase/ decrease the dose or maintain at the given dose to increase the effectiveness and stability of patient treatment.
(1) Why did you select this decision? Be specific and support your response with clinically relevant and specific- patient resources, including the primary literature.
(2 )Why did you not select the other Two medication options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
(3) What were you hoping to achieve by making this decision? Support your response with evidence and references including the primary literature.
(4) Explain how ethical considerations may impact your treatment plan and communication with the patient. Be specific and provide examples.
DECISION 3 (1 PAGE): What medication will you give either decrease/increase or maintain at given doses to achieve therapeutic effectiveness.
(1) Why did you select this decision? Be Specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
(2)Why did you not select the other two medications option provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources including the literature.
(3) what were you hoping to achieve by making this decision with this medication option? Support your response with evidence and references to the learning resources including the primary literature.
(4) Explain how ethical consideration may impact your treatment plan and communication with the patient. Be specific and provide examples.
CONCLUSION (1): Summarize your recommendation on the treatment options you selected for this patient . Be sure to justify your recommendation and support your response with clinically relevant and patient-specific resources, including the primary literature.
Support your rationale with a minimum of FIVE academic resources by utilizing the primary and secondary literature.