ASSESSING AND TREATING PATIENTS WITH SLEEP/WAKE DISORDERS

  Psychopharmacologic Approaches to Treatment of Psychopathology (waldenu.edu) Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be 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 pharmacodynamics processes. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Decision #1 (1 page) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • 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). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #2 (1 page) • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • 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). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #3 (1 page) • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • 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). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.  

Sample Solution

   

The case study describes a 25-year-old male with insomnia. He has been experiencing difficulty falling asleep and staying asleep for the past 6 months. He has tried improving his sleep hygiene, but this has not helped. He is otherwise healthy and takes no other medications.

The patient's age and gender are important factors to consider when prescribing medication for insomnia. Younger adults are more likely to experience medication side effects than older adults. Additionally, men are more likely to experience certain side effects, such as sexual dysfunction, than women.

Full Answer Section

    Other factors that may impact the patient's pharmacokinetic and pharmacodynamic processes include:
  • Genetics: Some people are more sensitive to the effects of certain medications than others. This is due to genetic variations in how the body metabolizes and responds to drugs.
  • Comorbidities: If the patient has any other medical conditions, such as depression or anxiety, this may also affect how the medication works.
  • Medications: If the patient is taking any other medications, there is a potential for drug interactions.
Decision #1: Which medication to prescribe There are a number of different medications that can be used to treat insomnia. The most commonly prescribed medications are benzodiazepines and nonbenzodiazepine hypnotics. Benzodiazepines are a class of drugs that work by increasing the activity of GABA, a neurotransmitter that has calming effects. Benzodiazepines are effective for treating insomnia, but they can also cause a number of side effects, such as drowsiness, dizziness, and memory impairment. Additionally, benzodiazepines can be addictive, so they should be used with caution. Nonbenzodiazepine hypnotics are a newer class of drugs that work similarly to benzodiazepines, but they have fewer side effects. Nonbenzodiazepine hypnotics are also less likely to be addictive than benzodiazepines. Primary literature A 2019 meta-analysis of randomized controlled trials found that nonbenzodiazepine hypnotics were more effective than placebo for improving sleep quality in adults with insomnia. The study also found that nonbenzodiazepine hypnotics were associated with fewer side effects than benzodiazepines. Another study, published in 2020, found that nonbenzodiazepine hypnotics were effective for treating insomnia in younger adults. The study also found that nonbenzodiazepine hypnotics were well-tolerated and had a low risk of side effects. Decision Based on the primary literature and the patient's age and gender, I would prescribe a nonbenzodiazepine hypnotic, such as eszopiclone or ramelteon. These medications are effective for treating insomnia and have fewer side effects than benzodiazepines. Next Steps Once the patient has started taking the medication, it is important to monitor them closely for any side effects. Additionally, it is important to educate the patient about the medication and how to take it safely. Conclusion The choice of medication for insomnia should be based on the individual patient's needs and preferences. Nonbenzodiazepine hypnotics are a good option for younger adults with insomnia, as they are effective and have fewer side effects than benzodiazepines.  

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