A 46-year-old white male client presents to the facility after being referred by his primary care provider. Chief complaints include heart attack, chest tightness, shortness of breath, and impending doom.

Assessing and Treating Patients with Anxiety Disorders

A 46-year-old white male client presents to the facility after being referred by his primary care provider. Chief complaints include heart attack, chest tightness, shortness of breath, and impending doom. The patient reports experiencing anxiety attacks and having the need to escape or run from wherever he is. History of presenting illness indicates that the client experienced a heart attack when he visited an emergency room. Socioeconomic history indicates that the client is single and a welder at a local steel fabrication factory. He lives with his parents in his home and attempts to care for them. He also claims the management at work is harsh, and he fears losing his job. Surgical history indicates that the patient had his tonsils removed at the age of 8 years. Medical history indicates the patient has mild hypertension and has never been on any psychotropic medication. The patient, however, admits to using ETOH to compart worries about work and consumes 3-4 bears per night. On weighing the patient, he was found to be overweight. Other findings of the physical examination were within the normal limits. ER tests are done, and myocardial infarction is ruled out. An EKG test is normal. Our assignment writing help is at affordable prices to students of all academic levels and academic disciplines.

Mental status examination shows that the patient is well dressed, alert, and oriented to person, place, time, and event. The speech is normal but reports a monotone, implying the patient’s feeling as nervous. The effect is blunt but brightens several times. No hallucinations or paranoid behavior was noted. Insight and judgment are intact, and the client denies any homicidal or suicidal ideation. HAM-A scale yields a score of 26. The patient is diagnosed with generalized anxiety disorder. The history of the patient, the assessment findings, and the tests helped to arrive at the diagnosis. The subjective data, objective data, assessment data, and the test also help identify the best medication for the patient based on the findings.

Decision #1

The decision selected is to begin Zoloft 50 mg orally daily. The patient presents with symptoms of anxiety, and he is diagnosed with general anxiety disorder. He should, therefore, be treated with drugs to reduce anxiety. Since the patient has never been on any psychotropic medication, he should be started on first-line agents for treating anxiety. First-line agents for treating anxiety are Zoloft and Paxil (Silvestro, 2021). In this case, there is no Paxil, and therefore, Zoloft was selected. Zoloft is an antidepressant, therapeutically and pharmacologically, a selective serotonin reuptake inhibitor (Kassis, 2020). The drug inhibits the uptake of serotonin by the neurons in the CNS, hence potentiating serotonin activity (Silvestro, 2021). Therefore, the drug leads to antidepressant action, decreased panic attacks, decreased feelings of intense fear, decreased feelings of horror, and decreased social anxiety (Kassis, 2020). The patient presents with panic attacks, fear, and anxiety, and therefore, Zoloft will be the best drug for his anxiety disorder. Zoloft also has fewer side effects compared to other drugs, making it the best choice.

The other two drugs, Imipramine 25 mg PO BD and Buspirone 10 mg PO BD were not selected because they are second-line drugs in the treatment of anxiety. This is the first time the client is starting psychotropic medications, and therefore, he should begin with first-line drugs (Bradley et al., 2018). Based on the assessment findings, the client has cardiovascular and respiration conditions. Giving the patient Imipramine and Buspirone would worsen the symptoms since the adverse effects of the medications include effects such as tachycardia (Bradley et al., 2018). Based on the decision I made, I was hoping to ensure that the patient’s anxiety is reduced with no or fewer adverse effects from the medication. The safest drug was to be given to the patient. Ethical considerations such as safety ensure the client is given the best drug, which leads to better outcomes. For example, the safest drug administered to the patient ensures safety and prevents unwanted effects (Rathi & Rathi, 2019). Ethical considerations also reduce medication errors. Ensuring the patient is given the right drug at the right dosage and time reduces medication errors.

Decision #2

In the second decision, I selected the dosage of Zoloft to be increased to 75 mg orally daily. The client has returned to the clinic after four weeks and reports decreased worries about work for the past 4 to 5 days. This indicates that the medication is working and, therefore, it should continue being used. A reduction in HAM-A