Special Considerations for Patient Populations (Essay Sample)

Special Considerations for Patient Populations Student’s Name Institutional Affiliation Special Considerations for Patient Populations * Patient 1: 82-year-old male presenting with cognitive decline. The most appropriate medication to prescribe to an 82-year-old male presenting with cognitive decline is Memantine. The choice of this medication has been informed by its proven role in managing symptoms of neurocognitive ailments like Alzheimer's (Guo et al., 2020). The rationale for choosing Memantine is backed by the fact that The FDA approves it for the treatment of symptoms of moderate to severe Alzheimer's disease. Further, this medication can be useful in managing symptoms of other neurocognitive disorders by moderating the glutamate activities hence improving cognitive function in some patients. The dosing schedule for memantine requires that it is started at a dose of 5 mg once daily, and then increased gradually to a level dose of 10 mg twice a day, as needed. Patient education is important on the benefits of this medication such as minimizing the progression of cognitive symptoms. The patient also needs to be taught the possible side effects which include dizziness, headache, and constipation. Other medications on the list are not appropriate for the diagnosis for the following reasons; Lorazepam and olanzapine have the potential to intensify confusion and deteriorate cognitive impairment in this patient because he is elderly, especially since he has a history of dementia and therefore would not be appropriate for a prescription. * Patient 2: 76-year-old female who recently moved from her home to an assisted living. The most appropriate medication to prescribe for the 76-year-old female showing signs of a UTI is Trimethoprim. The rationale for choosing this medication patient's symptoms, diagnosis, likely interactions, and cognitive state (Jent et al., 2022). The UTI symptoms in conjunction with her elderly age and having changed her environment might be greatly affecting her mental state. As a result, it is important to consider the likelihood of the medical interactions that elderly patients face especially those with mental illnesses. Trimethoprim is a safe antibiotic in this case as it does not affect her current medications and is also considered appropriate for her age and sensitivity to the medication has been proven. Valproate and Alprazolam are not appropriate for elderly patients since they are more likely to cause unwanted side effects such as confusion hence not recommended. It is necessary to perform laboratory tests and diagnostics before prescribing Trimethoprim by confirming UTI with urine culture, checking blood culture to confirm UTI, CBC to assess leukocytosis severity, BMP to evaluate renal function, and conducting a neurological examination. A neurological examination would also be ideal to assess cognitive status and to rule out neurological effects. The tests are important for accuracy in diagnosis and treatment. The patient’s mental status needs to be monitored closely within the context of her entire clinical picture. Other symptoms such as difficulties paying bills and managing her finances, irritability, verbal lashing out, and disorientation, are highly likely to point to underlying dementia or cognitive dysfunction. The dosage schedule should be balanced to treat the UTI without worsening any potential drug interactions or cognitive issues. If possible, short-term use of Trimethoprim would be ideal with a low dose start, close monitoring of the side effects, and regular reassessing for continuation. Alternative treatment solutions can come in handy to manage reported patient agitation and confusion such as non-pharmacological interventions like reorientation strategies, teaching the patient to maintain a calm and familiar environment, or involving family in the care plan. * Patient 3: A 33-year-old female that is 6 weeks postpartum. The most appropriate medication for the 33-year-old female who is 6 weeks postpartum is Sertraline. The rationale for choosing this medication patient's condition, diagnosis, and possible risk factors for the breastfeeding baby and dominant symptoms. Sertraline is an SSRI (Selective Serotonin Reuptake Inhibitor) effective in treating depression and is considered safe for breastfeeding mothers Guimarães Da-Silva et al., 2021). Other medications on the list are not appropriate for the diagnosis for the following reasons; Lithium is used for bipolar disorder as opposed to treating major depressive disorder hence not suitable in this case. Despite Paroxetine being an SSRI like Sertraline, it is not recommended in breastfeeding mothers due to its side effect of causing withdrawal symptoms in the infant. The dosing schedule for Sertraline has a starting dose of 50mg per day, taken twice per day, and can be increased gradually if needed, up to a maximum of 200mg daily. The therapeutic endpoint of this medication is minimizing the patient's depressive symptoms and improving sleep and appetite. Patient education is important to inform the patient of the likely side effects of this medication such as sleep difficulties, nausea, diarrhea, dry mouth, and loss of appetite. The patient also needs to be assured that this medication is safe for breastfeeding and will not have any adverse effects on the infant. Additionally, there is a need for collaboration with the patient’s partner and caregiver and they also need to be informed of the importance of showing support to the patient during the treatment Proper laboratory tests and diagnostics are essential before prescribing Sertraline. A complete blood count and liver function tests need to be done to ensure no underlying conditions are likely to contraindicate its use. On monitoring efficacy and side effects, the patient needs to be examined closely to check any side effects and improvements which can be achieved through follow-ups and reporting. Finally, if the patient does not adhere to this treatment plan, there would be a need to explore the cause and alternative treatment options and even including Psychotherapy. Also, if side effects are non-manageable, a different type of medication would be tried. * Patient 4: 10-year-old male has been diagnosed with generalized anxiety disorder. The most appropriate medication selection for the 10-year-old male diagnosed with generalized anxiety disorder would be Fluoxetine. The decision was informed by the patient's age, diagnosis, and the dominant symptoms. Fluoxetine is commonly used to treat anxiety disorders in children and adolescents, which is within the age range of the patient (Ansara, 2020). The dosing schedule for a 10-year-old is 10mg per day, which can be increased steadily when needed up to a maximum of 20mg per day. Patient education is important to review risks, side effects, and expectations: The patient and his father need to be taught the treatment plan and be informed that it takes several weeks to realize the full effects of the medication. They should be educated on the likely side effects of this medication, which are nausea, stomach upset, diarrhea, dry mouth, sleep difficulties, and excessive sweating. Rarely, the patient can experience more serious side effects, which can include suicidal ideation. Other medications on the list are not appropriate for the diagnosis for the following reasons; Quetiapine: This is an antipsychotic medication, used to treat illnesses like schizophrenia and bipolar disorder. It is not classified as the first-line medication choice for treating generalized anxiety disorder, especially in children. Another risk factor is that it is likely to cause serious side effects like weight gain and metabolic syndrome. Duloxetine: This medication is a serotonin medication used to treat depression and anxiety. It is not recommended to be prescribed for a 10-year-old due to a lack of available research on the safety and efficacy of children. It is necessary for proper laboratory tests and diagn...