(Solution) NURS 6630 Week 10 Assignment: Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction / A Puerto Rican Woman with Comorbid Addiction.

(Solution) NURS 6630 Week 10 Assignment: Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction / A Puerto Rican Woman with Comorbid Addiction. Assessing and Treating Patients with Impulsivity, Compulsivity, and Addiction Course: NURS-6630- Psychopharmalogical Approaches to Treat Psychopathology Week 10: Assignment 1 Walden University Introduction The provided case study is of Mrs. Maria Perez who is 53 years old Puerto Rican female. The case study indicated that she is suffering from alcohol use disorder and gambling disorder. The background information indicated that the patient became alcoholic after the death of her father and she is struggling with addiction to alcohol since her 20’s. She is now seeking for help because her addiction to alcohol and gambling has increased from the past two years. Patient reported that the reason behind her increased addiction is due to the opening of a new casino “Rising Sun” near her home. She and her friend went to visit the new casino at its grand opening and from that point she got “hooked”. Patient reported that she enjoys drinking alcohol during gambling because alcohol help her to remain calm during the high-stake games. Patient mentioned that she does not smoke during gambling but she smokes more when she is playing slot machines. Alcoholism has increased her weight from 115 lbs to 122 lbs. Patient is embarrassed because she borrowed over $50,000 from retirement account to pay off her gambling debts and her husband in not aware of this. The mental status examination indicated that she is oriented to person, place, time and event. Her speech is clear but she is avoidant to make eye contact during interview which indicates that she is embarrassed about herself. Self- reported mood is sad but she denies suicidal or homicidal ideation. Patient also denied paranoid or delusional thought process, auditory or visual hallucinations. Insight and judgment are grossly intact. The pertinent positive information that will impact decision making when prescribing medication for this patient include her age factor, addiction to alcohol, gambling and cigarette smoke, absence of information related to abstinence and impaired impulse control. Assessing and Treating Patients with Impulsivity, Compulsivity, and Addiction Decision 1 For decision 1 I selected “Vivitrol (Naltrexone) injection, 380mg intramuscularly in the gluteal region every four weeks”. I selected this decision because Naltrexone is considered as the first line medication for alcohol use disorder. According to the study of Spithoff et al. (2017) Disulfiram, Naltrexone and Acamprosate are the first line alcohol use disorder medications. Among these Disulfiram is a cost effective medication but Acamprosate and Naltrexone are safe and cost effective medications for the treatment of alcohol use disorder. The study discussed that Naltrexone not only helps patients in achieving abstinence but it also helps patients in reducing their heavy drinking to lower risk levels. On the other hand, Acamprosate is effective when therapy is initiated after detoxification. The use of Naltrexone does not depend on conditions but other drugs like Acamprosate is recommended only when the patient shows treatment failure with Naltrexone or Naltrexone is contraindicated in relevance to patient’s health status or the patient has shown abstinence for at least 4 days. Considering these facts, the other options of Disulfiram (Antabuse) and Acamprosate (Campral) are not selected. As the patient is already facing severe financial loss due to gambling, therefore in such conditions it would not be a prudent decision to recommend a cost effective medication like Disulfiram. The study has mentioned that Disulfiram is not accessible easily and it is only accessible through compounding pharmacies at a cost of approximately $150 annually