St Thomas University Pharmaco

Goal: To analyze and apply critical thinking skills in the pharmacokinetics and pharmacodynamics of psychopharmacological agents for patient treatment and health promotion while applying evidence-based research.

Chapter 9, Case 2Sam is a 35-year-old white male who lives with his girlfriend of 10 years. His family lives out of state, and he reports limited contact with them or friends. Sam reports that throughout his childhood school was “easy when [he] wanted to do it” but that he struggled to self-motivate when uninterested in a topic. Sam reports generally earning good grades in school, although he indicates that his assignments were generally “turned in at the last minute.” After high school, Sam attended trade school to become a photographer, and he reports previous employment as a photo editor and freelance photographer. Since leaving college, however, Sam reports difficulty maintaining meaningful employment, describing fears that he will “get bored and not return to work” and leading him to “disappoint everyone.”
Sam reports that in social settings he often likes to “be the center of attention” and that others often describe his behavior as “loud” and that he “doesn’t understand why.” During therapy, Sam evidences a similar level of increased volume and tangential speech, often changing topics midsentence when a newer topic becomes more interesting to him. Sam states that prior therapists attempted to treat him for bipolar disorder but that mood stabilizers and antidepressants had minimal therapeutic impact.
Presently, Sam remains unemployed, citing his fears over following through with any work-related tasks. Evaluations of Sam confirm that he struggles staying on task in nearly all settings, often forgetting key tasks until after their respective due dates.
Sam also reports a history of regular marijuana use, as well as occasional recreational use of cocaine “once or twice a year.

Questions:Remember to answer these questions from your textbooks and clinical guidelines to create your evidence based treatment plan. At all times, explain your answers. 

Summarize the clinical case.

Create a list of the patient’s problems and prioritize them.

Which pharmacological treatment would you prescribe? Include the rationale for this treatment.

Which non-pharmacological treatment would you prescribe?   Include the rationale for this treatment.

Include an assessment of treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.

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