Treatment for Neurological and Musculoskeletal Disorders
Neurological and musculoskeletal disorders are some of the complications that nurses handle from time to time. As such, it is the responsibility of the healthcare professionals to understand to identify the appropriate medications that are available in the management of the various complications associated with the two systems. In this paper, a detailed analysis of the treatment options for a 76-year-old patient with a major neurological disorder is provided.
The Case Study
The 76-year-old patient presents to the healthcare facility with what the son describes as strange behavior. Some of the symptoms of the patient’s condition include the loss of interest in some of the activities that he once liked such as religious matters. He has limited interest in activities that he once cherished and often ridicules these activities. It is thus of the essence to identify the best decisions based on the available options as far as the management of the patient’s Alzheimer’s disease is concerned.
Decision Step One
The best decision to consider in the management of the patient’s condition is the prescription of Aricept 5mg orally at bedtime. The medication is one of the most effective cholinesterase inhibitors compared to the other medications available in the first option (Gauthier et al., 2020). Aricept works by inhibiting the breakdown of acetylcholine, thus making it available for neurotransmission at the cholinergic synapse (Stahl, 2013). The other reason for prescribing Aricept over other medications available in this decision is that it has a longer half-life. Therefore, it does not have to be administered many times during the day.
By prescribing the medication, I anticipated the improvement in the patient’s signs and symptoms by the time the patient presents for a check-up. I would say that the goals associated with this initial decision were not met because the patient’s son comes with the father during the check-up and states that the symptoms are not getting any better. Therefore, the next decision should be influenced by the outcome of the first decision.
Decision Point Two
The appropriate decision to take in this second step is increasing the dose of donepezil from 5mg orally at bedtime to 10mg orally at bedtime. The efficacy of the medication may be recorded once the dose of the medication is increased (Regenold, Loreck & Brandt, 2018). At this point, a change in the medication may not be appropriate because of the associated costs. Besides, out of the provided medication options, Aricept is approved by the FDA as the most appropriate medication in the management of mental health conditions arising from Alzheimer’s disease (Bryan, 2020).
By making this crucial decision, I anticipated further improvement in the patient’s signs and symptoms. I would say that the patient’s goals were met because, at the time of check-up, the patient’s son stated that the tolerance to the medication was as expected. However, his situation was not fully resolved. The patient had started gaining interest in religious activities and was willing to attend the sessions with the family members.
Decision Step Three
In this the final treatment decision for the patient, I feel that continuing with Aricept 10mg orally at bedtime is an appropriate decision to make. As stated in decision point two, the patient’s tolerance to the medication has improved and he is getting better. Changing the medication at this stage may be associated with additional costs (Arowolo & Martin, 2020). Besides, the patient may take longer to tolerate the medication. By making this third decision, I look forward to further improving the neurological symptoms of the patient to ensure that his recovery process is as expected.
Ethical Considerations
In this patient case study, it is important to check on the available ethical considerations. Being that the patient has neurological complications, his behavior may not be appropriate because of the impairment. Therefore, the patient should be understood instead of being judged based on his behavior (Stahl, 2013). Besides, it is ethically right to include the patient’s son when making treatment decisions because of the parent’s mental state. The son should be told about the side effects associated with making each decision.
Conclusion
To conclude, it is essential for nurses and other healthcare professionals to understand the neurological effects associated with Alzheimer’s disease. The presented case points out that Aricept is one of the most effective cholinesterase inhibitors and should be used in the management of the patient’s condition. It is essential to closely monitor the patient during the treatment period for the various side effects of the medication.
References
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Arowolo, M., & Martin, T. (2020). Testing for a Better Alzheimer’s Disease Drug through Reinventing Aricept.
Regenold, W. T., Loreck, D. J., & Brandt, N. (2018). Prescribing Cholinesterase Inhibitors for Alzheimer Disease: Timing Matters. American family physician, 97(11), 700-700.
Bryan, J. (2020). Donepezil—a major breakthrough in the treatment of Alzheimer’s disease. Evaluation, 14(47), 19.
Gauthier, S., Feldman, H., Hecker, J., Vellas, B., Ames, D., Subbiah, P., … & Emir, B. (2002). Efficacy of donepezil on behavioral symptoms in patients with moderate to severe Alzheimer’s disease. International Psychogeriatrics, 14(4), 389-404.