what is the best Therapy for Clients with Impulsivity, Compulsivity, and Addiction?

Examine Case Study of A Puerto Rican Woman With Comorbid Addiction. 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. Provide rational for choosing one medication over the other two and also discuss the other two options in each decision point for all three decision tree level

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As a medical professor, when examining a case study of a Puerto Rican woman with comorbid addiction, several factors need to be considered before making decisions concerning the medication to prescribe. It is essential to consider the pharmacokinetic and pharmacodynamic processes that could impact the client’s health. The following are three decisions concerning medication to prescribe to the client.

Decision 1:
The first decision concerns prescribing either buprenorphine or methadone as medication to manage addiction in the client. Buprenorphine is preferable because it has partial mu-opioid agonist activity and high oral bioavailability. Additionally, it has a better side effect profile than methadone. However, the client may still experience adverse effects such as dizziness, headache, and sedation. Methadone, on the other hand, is a full mu-opioid agonist that relieves withdrawal symptoms and cravings. It requires daily supervision, and the client may develop opioid tolerance, dependence, and respiratory depression.

Decision 2:
The second decision involves prescribing an antidepressant medication to manage the client’s depressive symptoms. Sertraline is the preferred medication as it is a selective serotonin reuptake inhibitor (SSRI) that is safe and effective in treating depression. It also has a lower risk of causing weight gain, sedation, and anticholinergic effects compared to other SSRIs. Fluoxetine and citalopram are the other two options, but they pose a risk of prolonged QT interval and cardiovascular side effects, respectively.

Decision 3:
The third decision involves prescribing a medication to manage the client’s anxiety. Lorazepam is the preferred medication due to its rapid onset of action and short half-life, making it effective in the short-term management of anxiety. Diazepam and alprazolam are the other two options, but they have a higher risk of dependence, misuse, and tolerance. Diazepam has a long half-life making it unsuitable for short-term use, while alprazolam is associated with rebound anxiety and withdrawal symptoms.

Prescribing medication to clients requires careful consideration of the factors that might impact the pharmacokinetic and pharmacodynamic processes. The above decisions concerning medication to prescribe to this Puerto Rican woman with comorbid addiction considered the advantages and disadvantages of the medication options available, before arriving at a preferred choice.

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