Anxiety disorders refer to a group of mental disorders that affect a significant proportion of the world’s population. Individuals suffering from these disorders experience significantly elevated levels of fear. They also experience elevated worry concerning future or expected occurrences. Often, healthcare providers might face a challenge in differentiation between anxiety disorders and heart attack due to the closely related symptoms in these conditions (Timulak & McElvaney, 2017). Therefore, a careful review of the symptoms should be undertaken to determine the exact cause of the patient’s problem. The provided case for this assignment is an adult patient who came to the emergency department thinking that he had a heart attack. This could be seen from the symptoms he presented with such as dyspnea, tightness of the chest, and feelings of impending doom. A careful examination of the patient revealed that the EKG was normal with HAM-A scale of 26, which implies that he is suffering from anxiety disorder rather than heart attack. Consequently, this research paper explores the decision pathways that can be adopted to manage the patient’s anxiety disorder.
Decision Point One
Selected Decision
The selected decision for point one would be starting the patient on Zoloft 50 mg PO BD daily
Reason for Selection
The first decision in managing the client’s health problem is the administration of PO Zoloft 50 mg BD for 2/7. This decision was reached due to the existing evidence that demonstrates the effectiveness of Zoloft in the management of general anxiety disorder. According to McKay, Abramowitz and Storch (2017), Zoloft belongs to a group of drugs called selective serotonin reuptake inhibitors. It works by blocking the reuptake of serotonin at the receptor sites. The selectivity of Zoloft has made it an effective agent against conditions that include depression and anxiety disorders. The decision to consider it was also informed by the fact that its use is associated with minimal adverse effects to the patient. It can be seen from the case that the patient does not have any history of use of psychotic medication. As a result, it would be advisable to start him with Zoloft since it can result in faster resolution of the symptoms that the patient is experiencing.
The use of Imipramine can be considered for managing the condition of the patient. This drug belongs to the class of Tricyclic antidepressants, which have been shown to be more effective than selective serotonin reuptake inhibitors. However, Imipramine is not an alternative medicine to use in this patient due to its prolonged duration of action, which might increase the patient’s vulnerability to adverse effects of the drug. The drug can also potentiate the risk of adverse outcomes such as tachycardia and abnormal EKG findings. Therefore, Imipramine is not an effective alternative drug for this patient. Buspar has also been shown to be effective in the management of general anxiety disorders. However, its use is not recommended in this patient due to its slow metabolism, which can raise toxicity associated with it (McKay et al., 2017). Consequently, Zoloft remains the best alternative drug to prescribe to this patient, as it has enhanced safety and efficacy when compared to the rest.
Expected Results
The use of Zoloft is expected to result in a reduction in the symptoms that the patient presented with to the emergency unit. It is estimated that the use of the drug will result in a 50% decline in the symptoms with a significant reduction in fears by the end of four weeks. Therefore, the client’s quality of life is anticipated to improve by this time.
Differences between Expected Results and Actual Results
The client was booked for a follow-up clinic visit at four weeks. He reported that there was a significant reduction in dyspnea, chest tighteness, and fear. He was now able to focus on his work. There was also a reduction of HAM-A scale to 16 from 26. Therefore, the outcome revealed moderate effectiveness of the intervention, hence, making it a desirable approach to treating generalized anxiety.
Decision Point Two
Selected Decision
The second decision point I would consider is increasing the dosage of Zoloft to 75 mg BD twice a day.
Reason for Selection
The above analysis revealed that Zoloft is effective in treating the symptoms of the patient. It would therefore be necessary to raise the dosage of the drug to 75 mg PO BD for two days. The consideration for this decision is informed by the fact that the initial dosage resulted in the reduction of symptoms of chest tigheness and dyspnea. However, the symptoms have not resolved comple
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