Medication Guide for a 72-Year-Old Male with Major Depressive Disorder and Panic Disorder

by | Jun 10, 2024 | Nursing

Patient 3: 72-year-old male with diagnosis of major depressive disorder and panic disorder. He has cardiac history and takes antihypertensive medications.
Step 2: Create a Medication Guide (a GUIDE NOT PAPER) for a patient. In your guide, you should provide the following specific instructions for the patient:
· Describe the chosen classification of medications, from the classification category, for your chosen vulnerable patient. Explain your rationale for your choice.
· Explain what dose you would start the chosen medication with and the frequency.

· Discuss how the medication works to treat their symptoms.
· Explain how long they should take the medication.
· Discuss the typical or common side effects of the medication.
· Explain the urgent or emergent considerations for the patient taking the medication.
The Medication Guide should also include:
· Directions you would provide the patient on how to take the prescribed medication
· Instructions on what the patient should do if a medication dose is missed
· List of any other medications, over-the-counter medications, and/or supplements/herbals the patient should avoid while taking the prescribed medication
· List of foods the patient should avoid when taking this medication
· Date when the patient should return for follow-up visit with you
· Discussion about the legal and ethical considerations for the medication being prescribed
· Answers in consideration of Social Determinants of Health on how you would:
o Assist the patient who cannot not afford to pay financially for the medication you are recommending/prescribing; and/or
o Has difficulty with transportation that impacts their ability to present for regular appointments with you
· Discuss how financial hardship and lack of transportation could relate to Social Determinants of Health, as well as why they are important considerations for you as a prescriber.

 

 

 

Sample Answer

Sample Answer

 

 

 

 

Medication Guide for a 72-Year-Old Male with Major Depressive Disorder and Panic Disorder

Classification of Medication:

For a 72-year-old male with major depressive disorder and panic disorder, I would choose Selective Serotonin Reuptake Inhibitors (SSRIs) as the classification of medications. SSRIs are commonly prescribed for these conditions due to their efficacy in treating symptoms of depression and anxiety disorders while having a relatively favorable side effect profile, especially in older adults with cardiac history.

Starting Dose and Frequency:

Start with a low dose of the chosen SSRI medication, such as Sertraline 25mg once daily. The dose can be gradually titrated upwards based on the patient’s response and tolerability, under the guidance of a healthcare provider.

Mechanism of Action:

SSRIs work by blocking the reabsorption (reuptake) of serotonin in the brain, which helps to increase the levels of serotonin available. This neurotransmitter is involved in regulating mood, emotions, and anxiety levels. By enhancing serotonin levels, SSRIs can alleviate symptoms of depression and panic disorder.

Duration of Treatment:

The patient should continue taking the medication as prescribed by their healthcare provider. It is important to understand that the full therapeutic effects of SSRIs may not be felt immediately, and it might take several weeks for the medication to reach its maximum effectiveness. Therefore, long-term treatment may be necessary to manage symptoms effectively.

Common Side Effects:

Common side effects of SSRIs may include nausea, insomnia, headache, dizziness, and sexual dysfunction. It is essential for the patient to report any side effects to their healthcare provider promptly.

Urgent Considerations:

If the patient experiences severe adverse effects such as suicidal thoughts, allergic reactions, or serotonin syndrome (signs include confusion, hallucinations, rapid heart rate), they should seek immediate medical attention.

Directions for Medication Use:

Take the medication with food to minimize gastrointestinal side effects. Do not crush or chew the tablets. Follow the prescription instructions carefully.

Missed Dose Instructions:

If a dose is missed, take it as soon as remembered unless it is close to the next scheduled dose. Do not double the dose to catch up.

Medication Interactions:

Avoid taking MAOIs (Monoamine Oxidase Inhibitors), other antidepressants, St. John’s Wort, and certain pain medications while on SSRIs. Consult with your healthcare provider before starting any new medications or supplements.

Foods to Avoid:

There are no specific foods that need to be avoided while taking SSRIs.

Follow-Up Visit:

The patient should return for a follow-up visit in 4 weeks to assess treatment response and monitor for side effects.

Legal and Ethical Considerations:

As a prescriber, it is essential to ensure informed consent, confidentiality, and adherence to prescribing guidelines and regulations when recommending medications. Patient autonomy and safety should be prioritized.

Social Determinants of Health Considerations:

– Financial Hardship: Connect the patient with prescription assistance programs, generics when available, or alternative treatment options. Discuss cost-effective strategies.
– Transportation Difficulties: Explore telehealth options for appointments or assist in arranging transportation services for clinic visits.

In conclusion, addressing financial hardship and transportation issues is crucial for optimizing treatment outcomes and adherence. By considering social determinants of health, prescribers can ensure holistic care that addresses barriers to medication access and healthcare services for vulnerable populations.

 

 

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