Discussion Part Two (graded)
Subjective
39 year old female with adhedonia and depressed mood the past several months
Objective
Pertinent positives –
Barbara is a married female, smokes 1 pack/day, experiencing fatig
...
Discussion Part Two (graded)
Subjective
39 year old female with adhedonia and depressed mood the past several months
Objective
Pertinent positives –
Barbara is a married female, smokes 1 pack/day, experiencing fatigue, feelings of
worthlessness, appetite disturbances, weight gain, lack of concentration, insomnia, and
psychomotor disturbances.
Weight 180lbs (overweight, possibly obese) height needed
Anhedonia – lack of interest or pleasure in normal activities
Pertinent negatives – no children, has not needed therapy for 20 years
Pertinent + in RED
Pertinent – in BLUE
Assessment
Major Depression Disorder
Current Plan
Sertraline 50 mg PO daily
Monitoring for efficacy and toxicity of the current drug regimen you prescribed in Part One
Sertraline (Zoloft) – belonging to the Selective Serotonin Reuptake Inhibitors (SSRI), symptom relief
usually is seen within 3 to 6 weeks. During the acute treatment phase, which begins when diagnosed
and generally lasts 6 to 8 weeks, medication is started at a low dose and is increased until desired
response is achieved. During this period, if Barbara doesn't feel any positive effects on Zoloft after this
initial period, then she needs to come back in to the clinic to begin the gradual reduction of the dose to
eventually stop taking sertraline and try another antidepressant medication (Edmunds & Mayhew, 2014;
Qaseem et al., 2016).
Sertraline toxicity monitoring begins with a careful physical examination and checking for possible
overdose. Sertraline overdosage signs and symptoms are somnolence, vomiting, tachycardia, nausea,
dizziness, agitation, tremor, bradycardia, bundle branch block, coma, convulsions, delirium,
hallucinations, hypertension, hypotension, manic reaction, pancreatitis, QT-interval prolongation,
serotonin syndrome, stupor, syncope and Torsade de Pointes. Laboratory testing to monitor for sertraline
toxicity includes serum and urine toxicology screen. Other laboratory test are total creatinine
phosphokinase, blood urea nitrogen, creatinine levels, complete blood count, basic electrolytes, liver
function test, and urine myoglobin. If
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