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By Day 6 of Week 8
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD. In addition, suggest different treatment options you would suggest to treat a patient with the topic of discussion.
Colleague 1
COLLAPSE
Generalized anxiety disorder (GAD) is excessive anxiety over life events such as outward performance in school, work, marriage, social status, and including but not limited to finances; its prevalence is higher amongst high-income countries, higher incidence levels amongst women, and usually emerge in the early 20s (Rosenthal and Burchum, 2017). Signs and symptoms of GAD include irritability, restlessness, fatigue, problems with sleep, difficulty concentrating, and muscle tension; severe impairments can impact the quality of life and impact physical and emotional wellness (Chen, et. al., 2019). Non-drug therapy approaches of treatment include supportive therapy, cognitive behavioral therapy, reinforcing and educating patients on effective coping skills, and relaxation training; when symptoms become disabling, medication therapy is indicated. Medications approved for treatment include benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).
In personal experience related to patient diagnosis of GAD, the patient was an African American middle-aged woman with multiple comorbidities including comorbid psychiatric diagnosis. The patient was on several mood suppressive drugs at high doses due to a history of schizophrenia, suicidal and homicidal tendencies and attempts, as well as diabetes, hypertension, heart failure, and obesity to further add to the complexity of ineffective therapy interventions. The patient had several episodes of medication non-compliance and during this shift, had a behavioral outburst requiring as needed Ativan 5 mg daily for the behavioral outburst. The significance of the pharmacodynamics was the fact the patient was on one of the highest doses possible due to the high tolerance of the patient and the factors of the comorbidities. Anxiolytics do accumulate in the blood and must be prescribed with care; the patient in question was tall in stature and girth, with a prior history of substance abuse; “A frequent complication of GAD is substance abuse, which may result from self-medication with alcohol or drugs to relieve anxiety symptoms” (Huether & McCance,2019, pg. 613). Further treatment interventions for the patient would have been supportive therapy, cognitive and behavioral therapy, as well as individual therapy to teach and evaluate effective coping skills.