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I’m Struggling with understanding this case study. Could really use some help? Thanks in advance

 

 

CASE STUDY Assignment: Psychotherapeutic Drugs

 

Ms. Adams is a 38-year-old woman referred to an outpatient mental health center by her primary care provider. She has complained of “persistent headaches, nausea, fatigue, and difficulty staying asleep” for the past several months. She is constantly worried about her “finances” and “paperwork at the office” and finds it increasingly difficult to concentrate at work. At times she feels as if her mind has gone blank.

Ms. Adams’s past medical history includes benzodiazepine use (e.g., diazepam, lorazepam) for a variety of somatic complaints (GI upset, persistent headaches, insomnia), although she is not currently using a benzodiazepine.

Ms. Adams’s social history includes use of tobacco (smokes 2 packs per day), coffee (consumes 3 to 4 cups per day), and alcohol (drinks socially 3 to 4 drinks per week, with an occasional drink at night to help her sleep). She is employed as a market research analyst for a company with international prospects.

A psychiatric evaluation has confirmed a diagnosis of generalized anxiety disorder (GAD), with duration of greater than 6 months.

Data Obtained From Nursing Assessment

ï‚· Patient states: “I feel nervous most of the time.”

ï‚· Vital signs: blood pressure, 145/90 (right arm); pulse, 75; respiration, 18;

ï‚· Height, 5ft 5 in; Weight, 128 lbs

ï‚· System review is WNL. Denies SOB, palpitations, muscle aches, dizziness, diarrhea, diaphoresis, and hot flashes.

ï‚· Lungs are clear to auscultation and percussion.

 Alert and oriented ×3 (person, place, and time), reflexes are symmetrical; normal muscle strength, gait, and sensation

 

Lab Data

ï‚· Sodium: 138 mEq/L, Potassium: 4.1 mEq/L, Chloride: 103 mEq/L

ï‚· BUN: 12/mg/dL, Serum creatinine: 1.2 mg/dL

ï‚· Glucose: 108 mg/dL, fasting

ï‚· Hemoglobin: 14.9 g/dL, Hematocrit: 42%, Platelets: 244,000, WBCs: 4,600/mm3

 

Current Drug Therapy

ï‚· Alprazolam (Xanax), 4 mg/d in divided doses

 

1.     1. What is the rationale for Ms. Adams taking alprazolam for generalized distress?

 

 

 

 

2.     Are there any precautions or contraindications that would eliminate the use of alprazolam for Ms. Adams?

 

 

 

 

3.     What other anxiolytic drugs could be used to treat Ms. Adam’s GAD?

 

 

 

 

 

 

4.     What aspects of alprazolam (drug knowledge) are especially relevant to consider because they may interact with the patient variables?

 

 

 

 

5.     What patient variables are most important to consider for Ms. Adams when assessing her drug therapy?

 

 

 

6.     What actions are indicated to minimize adverse effects?

 

 

 

 

7.     What teaching is required for Ms. Adams regarding her drug therapy

SCIENCE
HEALTH SCIENCE
NURSING
PHARM 293

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