NURS 6630 Assessing and Treating Patients With Anxiety Disorders Decision #1

NURS 6630 Assessing and Treating Patients With Anxiety Disorders Decision

Selected Decision and Rationale

It is recommended to start treatment with Paxil by taking a daily oral dosage of 10 mg. The FDA has granted authorization for the use of Paxil in adults to treat anxiety-related diseases because of its favorable safety profile, supported by evidence-based practice and demonstrated effectiveness (Tafet & Nemeroff, 2020). Paxil is categorized as an SSRI medicine, which stands for selective serotonin reuptake inhibitor. Previous studies have shown the efficacy of paroxetine in treating anxiety-related issues, even at lower doses (McGowan, 2020). Furthermore, it has a good tolerance profile, devoid of dependence potential, and remains generally safe even when used excessively. Enhanced systemic circulation and lower drug metabolism in the liver are characteristics of the CYP2D6*4 variant allele (Melaragno, 2021). Polymorphism, which allows for the use of lesser doses of medicine, is particularly relevant for persons of Caucasian ancestry.

Particularly in the elderly, imipramine is contraindicated for the treatment of anxiety due to its inefficacy and accompanying risks. Moreover, the medication has been associated with increased body weight, potentially posing challenges for individuals in maintaining weight (Creswell et al., 2020). Conversely, buspirone has limited safety in middle-aged and elderly adults, indicating that it should only be used when no safer options are available. The patient’s alcohol use heightens the likelihood of developing a dependency on this medication (Szuhany & Simon, 2022).

Expected Outcome

The patient’s symptoms are anticipated to decrease by a minimum of 50% during the next four weeks. Negative responses, such as dizziness and headache, are expected to disappear independently (Bandelow, 2020). The patient’s Hamilton Anxiety Rating Scale score must be less than 10.

Ethical Consideration

The PMHNP has a legal duty to safeguard the well-being of patients and prevent any harm to them (Tafet & Nemeroff, 2020). When choosing the most suitable treatment plan, it is crucial to consider the patient’s ability to make independent decisions and ethical principles, such as promoting well-being and avoiding harm (Lee & Stein, 2022).