Explain how ethical considerations may impact your treatment plan and communication with patients.

Formal Decision Tree Introduction to the case (1 page)Brieflyexplain and summarize the case for this assignment. Be sure to include thespecific patient factors that may impact your decision making whenprescribing medication for this patient.Beaware that the writing template and grading rubric require yourintroduction to end with one sentence that is your thesisstatement. See the writing template for format and the gradingrubric for details on how you are graded on this statement.Body of your documentThebody of your document should contain three sections that are labeled asfollows: decision #1, decision #2, and decision #3. Eachsection should address the topics below. In your writing, you shouldbe concise, clear, and thorough. Pharmacokinetics, pharmacodynamics,and specific patient factors must be considered in your writing in orderto get full credit.Decision #1 (1 page)Whichdecision did you select?Whydid you select this decision? Be specific and support your response withclinically relevant and patient-specific resources, including the primaryliterature.Whydid you not select the other two options provided in the exercise? Bespecific and support your response with clinically relevant andpatient-specific resources, including the primary literature.Whatwere you hoping to achieve by making this decision? Support your responsewith evidence and references to the Learning Resources (including the primaryliterature).Explainhow ethical considerations may impact your treatment plan andcommunication with patients. Be specific and provide examples. *Ethicalconsiderations must be clearly identified/labeled. You can identifythem within the decision section (“My ethical considerations are…”), oryou can identify them separately in a section labeled “EthicalConsiderations.” Either option is acceptable.Decision #2 (1 page)Whydid you select this decision? Be specific and support your response withclinically relevant and patient-specific resources, including the primaryliterature.Whydid you not select the other two options provided in the exercise? Bespecific and support your response with clinically relevant andpatient-specific resources, including the primary literature.Whatwere you hoping to achieve by making this decision? Support your responsewith evidence and references to the Learning Resources (including theprimary literature).Explainhow ethical considerations may impact your treatment plan andcommunication with patients. Be specific and provide examples.Decision #3 (1 page)Whydid you select this decision? Be specific and support your response withclinically relevant and patient-specific resources, including the primaryliterature.Whydid you not select the other two options provided in the exercise? Bespecific and support your response with clinically relevant andpatient-specific resources, including the primary literature.Whatwere you hoping to achieve by making this decision? Support your responsewith evidence and references to the Learning Resources (including theprimary literature).Explainhow ethical considerations may impact your treatment plan andcommunication with patients. Be specific and provide examples.Conclusion (1 page)Summarizeyour recommendations on the treatment options you selected for thispatient. Be sure to justify your recommendations and support your responsewith clinically relevant and patient-specific resources, including theprimary literature.Generalized Anxiety DisorderMiddle-Aged White Male With AnxietyDecision Point One
Begin Buspirone 10 mg orally BIDRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksClient reports slight decrease in symptomsClient states that he still feels very anxiousHAM-A score decreased from 26 to 23Decision Point Two
Increase buspirone to 10 mg orally TIDRESULTS OF DECISION POINT TWOClient returns to clinic in four weeksClient reports no change in his anxietyHAM-A score has decreased from 23 to 22Decision Point Three
Discontinue buspirone and begin Zoloft 50 mg orally dailyGuidance to StudentIt is clear that buspirone has resulted in treatment failure as the client’s original HAM-A score was 26- a change in score from 26 to 22 is less than a 25% improvement in symptoms which constitutes treatment failure. It would not be appropriate to continue the same dose and reassess in 4 weeks as onset of therapeutic action for buspirone is around 2 weeks. At least a modest improvement should have been noted by now, if the drug were to work. If the client is having no side effects, you can discuss the possibility of increasing dose and re-evaluating in another 4 weeks. However, if the client remains distressed by his symptoms, the appropriate course of action would be to discontinue the buspirone and begin SSRI therapy with an agent such as Zoloft 50 mg orally daily.
Augmentation with an agent such as lorazepam 0.5 mg orally TID would not be appropriate at this time as the client needs a treatment plan for the long-term. You should never start someone on a benzodiazepine for an indefinite course of treatment as this could lead to addiction. Benzodiazepines should be used for a limited course of treatment for very specific therapeutic endpoints (for instance, to combat the initial activation which may be seen in the first few weeks after beginning an SSRI or SNRI).