Problem: Please read the Case Study below:
Cindy is a 29-year-old Caucasian female who lives alone. She graduated from college with a BS in Business Administration. Soon after graduation she began working for a large international corporation as assistant manager in their purchasing department and has remained at this job to the present. She is an only child and is close with her parents, especially her mother. She and her mother talked daily until her employment required a move out of state. Before the move, she dated occasionally but has never had a long-term relationship.
Cindy loves her job and enjoys the travel that is required. Approximately 2 years ago she noticed that she was feeling "blue" a lot. Her appetite had decreased and she had lost a little weight which she did not need to lose. She also began having difficulty going to sleep and would awaken several times during the night. She made an appointment with a family medicine practitioner who prescribed Trazodone 100 mg to 200 mg at night to help with her sleep. The Trazodone helped with her sleep but she was still feeling "blue" most of the time.
A friend at work suggested she try taking St. Johns Wort. Her friend had used it and said it had really helped her feel better. Cindy began taking St. Johns Wort 300 mg three times a day and noticed a change in her mood after about a week of taking the medication. She has continued taking the medication to the present.
Recently, Cindy has noticed that even with the St. Johns Wort and the Trazodone she is beginning to have problems with her mood. She just does "not feel happy." She has lost interest in most of her previous activities, has stopped going out with her friends, doesn't want to eat, and finds it difficult just to get up and go to work.
She calls her physician for an appointment but he is booked up for the next four weeks. She calls another physician that was recommended by a friend and gets an appointment for the same day. The new physician starts her on duloxetine 30 mg daily for 1 week then increase to 60 mg daily. The physician told Cindy that it might take three to four weeks before she will see any significant change in her mood.
After taking the duloxetine for 1 week she increases the dosage to 60 mg daily. She has been on the increased dosage for three days at this time. Shortly after arriving at work she begins to feel restless and agitated for no noticeable reason. Her head begins to hurt and she feels nauseated. As she attempted to complete her work she seems confused about what she is to be doing. A friend at work notices that her pupils appear dilated and she feels like she has a temperature. The friend suggests she see a doctor. When Cindy arrives at the doctor's office her temperature is 103 degrees, her heart rate is 125, her headache has increased, and she is hypertensive. The physician orders laboratory studies and finds no indications of a biological or viral infection. Need Assignment Help?
Then, answer the question below:
Pharmacy and Over-the-Counter Pharmacology List:
- St. John's Wort
- Omega-3
- Robax
- Cetirizine
- Dextromethorphan
- Melatonin
- Ibuprofen
- SAM-e
- Dramamine
- Nicorette
- Diphenhydramine
- Pseudoephedrine hydrochloride
- Paracetamot
Considering the possible side effects of this classification of drugs, and the symptoms of the client's diagnosis, from the list of medications provided above, what would be the top three medications that would be effective for this client and why? List three different medications, their suggested dosages, frequencies to start the medications, and how to progress the dosages to therapeutic dosages. Why would these medications be effective? The "why" should include which neurotransmitters are affected, how they are affected and what behavior, emotion, etc., should change, and what you should be able to observe.
The paper should be an essay, not in question/answer format. The essay should be formatted properly using APA guidelines and appropriate third-person grammar and at least 2 or more references listed below:
Preston, J.D., O'Neal, J.H., & Talaga, M.C. (2025). Handbook of Clinical Psychopharmacology for Therapists (10th ed.). New Harbinger Publications, Inc.
Preston, J.D., O'Neal, J.H., & Talaga, M.C. (2021). Child and Adolescent Clinical Psychopharmacology Made Simple (4th ed.). New Harbinger Publications, Inc.
Shannon, M.T., Wilson, B.A., & Shields, K. (2018). Pearson Health Professional's Drug Guide 2017-2018. Pearson/Prentice Hall.