THE ASSIGNMENT: 5 PAGES Examine Case Study: A Puerto Rican Woman With Comorbid A

THE ASSIGNMENT: 5 PAGES
Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic 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.
Conclusion (1 page)
Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.
Chapter 13, “Impulsivity, Compulsivity, and Addiction” (pp. 538-578)
Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders: Treatment improvement protocol seriesLinks to an external site., no. 32. http://www.ncbi.nlm.nih.gov/books/NBK64350/
Chapter 1, “Substance Use Among Adolescents”
Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”
Chapter 7, “Youths with Distinctive Treatment Needs”
University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control. Journal of Psychosocial Nursing & Mental Health ServicesLinks to an external site., 54(4), 15.
Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical PharmacologyLinks to an external site., 77(2), 375–381. https://doi.org/10.1111/j.1365-2125.2012.04457.x
Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse. Human PsychopharmacologyLinks to an external site., 30(3), 164–172. https://doi.org/10.1002/hup.2467
Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological NursingLinks to an external site., 42(4), 10–15. https://doi.org/10.3928/00989134-20160314-04
Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual DiagnosisLinks to an external site., 8(1), 74–84. https://doi.org/10.1080/15504263.2012.648439
Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., Olvera, R., Swann, A. C., & Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive PsychiatryLinks to an external site., 55(6), 1337–1341. https://doi.org/10.1016/j.comppsych.2014.04.018
naltrexone (revia/vivitrol)
naloxone
acamprosate
DisulfiramLupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., Cinose, E., Di Iorio, G., Di Nicola, M., & Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014Links to an external site.. https://doi.org/10.1155/2014/537306
Case Study: A Puerto Rican Woman with Comorbid AddictionLinks to an external site.
Note: This case study will serve as the foundation for this week’s Assignment.
Decision Point One
Antabuse (disulfiram) 250 mg orally every morning
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
Mrs. Perez reports to the office complaining of sedation, fatigue, and a “metallic taste” in her mouth, which “seems to be going away.” She also reports that she had just one drink about 5 days after starting the drug and thought that she would “die.” She reports that her face was red, and she felt that her heart would “pound right out of my chest.”
Mrs. Perez also reports that she continues to visit the casino but has not been spending as much money there. She has noticed that her cigarette smoking is increasing
Decision Point Two
Continue current dose of Antabuse and begin Wellbutrin (bupropion) XL 150 mg orally daily
RESULTS OF DECISION POINT TWO
Client returns to clinic in four weeks
Mrs. Perez reports that the side effects of the Antabuse are “gone” and that she is feeling much better
She reports that she is still smoking but that “it has dropped to only a couple of cigarettes a day.”
She still reports that she is visiting the casino but is not spending “as much money” as she had been in the past
Decision Point Three
Maintain current doses of each medication and refer to counseling for her gambling
Guidance to Student
Sedation/fatigue is a common complaint of people who take Antabuse, the best approach would be to change the administration time to the evening. The “metallic” taste in Mrs. Perez’s mouth is also another side effect that lessens and may fully go away with the passage of time. When a person taking disulfiram ingests alcohol, they will probably experience “flushing,” tachycardia, nausea, and vomiting.
At this point, you should maintain the current dose of each medication and refer the client to a counselor. Recall that there are no FDA-approved medications for the treatment of gambling addiction, and counseling is the mainstay of treatment for this particular disorder.
Nothing indicates an increase the Wellbutrin. Recall that it could take as long as 12 weeks for this medication to exert its full therapeutic effect. Cognitive behavioral principles can also be employed to help Mrs. Perez stop smoking, in addition to the Wellbutrin.
Although controversy exists in the literature regarding how long to maintain a client on Antabuse, 8 weeks is probably too soon to consider discontinuation.
Needs to include 5 APA references. Thank you!