Case study discussion week 7: Subjective: A patient presents to your care office today with a chief complaint of insomni

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Case study discussion week 7: Subjective: A patient presents to
your care office today with a chief complaint of insomnia. The
patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41
years passed away 10 months ago. Since then, she states her
depression has gotten worse as well as her sleep habits. The
patient has no history of depression prior to her husband's death.
She is awake, alert, and oriented x3. The patient normally sees PCP
once or twice a year. The patient denies any suicidal ideations.
The patient arrived at the office today by private vehicle. The
patient currently takes the following medications: Metformin 500 mg
Bid, Januvia 100mg daily, Losartan 100 mg daily, HCTZ 25 mg daily,
and Sertraline 100 mg daily. Current weight:88 mg, height 64
inches;., Tempm98.6, BP 132/86
Post a response to each of the following:
. List three questions you might ask the patient if she were in
your office. Provide a rationale for why you might ask these
questions.
. Identify people in the patent's life you would need to speak
to get feedback from to further assess the patient's
situation. Include specific questions you may ask
these peoples and why.
Explain what, if any, physical exams, and diagnostic tests,
would be appropriate for the patient and how the results would be
used.
. List two pharmacologic agents and their dosing that would be
appropriate for the patient's antidepressant therapy based on the
pharmacokinetics and pharmacodynamics. from a mechanism of action
perspective, provide a rationale for why you might choose one
agent over the other
. List a differential diagnosis for the patient identify
the one that you think is most likely and explain why.
. For the drug therapy, you select, identify, and
contraindications to use or alterations in dosing that may need to
be considered based on ethical prescribing or decision making.
Discuss why the contraindication/alteration you identify exists.
That is, what would be problematic with the use of this drug in
individuals based on ethical prescribing guidelines or
decision-making.
.