Rational Drug Selection Discussion

Order Description
• Include the question in your paper with your response below it.
• Minimum of 3 references within the last 5 years
• Drug reference books may be used. The Medical Letter & ALOSHA Foundation materials may be used.
• Peer reviewed articles from www.emedicine.com and www.uptodate.com may be used but they must be cited correctly
o Discuss the rationale for your drug selection. Include:
? – The medication is – Escitalopram
? – The drug class it belongs to is – Selective Serotonin Reuptake Inhibitors (SSRI’s)
? – Why have you selected this medication in this situation?
? – Justify your selection over the alternatives.
? – Why did you chose this med and not others?
? – What is the pharmacodynamic action of the medication you choose versus the other options. Include either a research article or an evidence-based guideline that supports your decision – making and selection process. Give your rationale, and reference your information.
o What monitoring or follow-up is needed for your treatment plan? Include:
? – How is the efficacy of this medication monitored?
? – Are there lab tests or other follow-up needed for patients on this medication?
? – How do you know the medication is efficacious?
o Talk about 3-5 instructional points you would include in educating the patient/caregivers about this medication? Make this meaningful.
o What is the cost of this medication? Include:
? – How does it compare with other options available for this patient?
? – What is the difference in cost between the generic form and Trade name drug?
? – Is the medication on the $4 lists available at area stores (Walmart, Target, etc.)?

CASE DISCUSSION:
Assessment: Anxiety

Patient: Judy
Age 50

Subjective
CC: anxiety
HPI: Patient presents to the office to anxiety. Has periods where she feels very jittery and nervous. Has a hard time concentrating at work. Has been under a lot of stress at work for the last 2 months and mother has been ill and hospitalized in the last month.

PMH- none
Family history- DM2 in father
Social history- Nonsmoker, nondrinker
Allergies- NKA
Medications- MVI daily
LMP- 4 months ago – not sexually active
ROS
General: fatigued
Skin: no rashes
ENT: no ear pain, no sinus pressure, no sore throat
Neck: no swollen glands or neck pain
Resp: no cough or SOB
CV: no CP or palpitations
Neuro:no HA, no dizziness
MSK: no myalgias
Psych: feels anxious and nervous

Objective
Physical exam
General: WD/WN BP 120/70, pulse 80, respirations 18, temp 98.2
Skin: No visible rashes
ENT: TM’s clear bilaterally, Nasal membranes pink
Neck: no palpable lymph nodes, full ROM
Resp: Lungs clear B/L
CV: Heart regular, pedal pulses +2/4
GI: Abdomen soft/ nontender, no organomegaly, normoactive bowel sounds in all quadrants
Psych: Alert, oriented x3, has rapid nervous speech, decreased eye con