Medical Treatment of Alcohol Use Disorder

Introduction

The case scenario for this particular medical situation involves a 31-year-old man who has a medical condition, insomnia, and is worried about how the condition has changed the quality of his life. The patient has suffered the effects of the condition for the past six months, with it getting gradually worse over time. The man’s parent says that the man was never a great sleeper, but the situation now prolonged sleep deprivation causes insomnia. He cannot fall asleep throughout the entire time, and at no time does he find himself enjoying rest because he cannot stay asleep for long enough time. The man began experiencing the problem of insomnia after the death of his fiancé six months ago. Therefore, the condition may have been associated with the psychological trauma that the fiancé’s demise brought into his life.

Condition and Treatment

This condition has affected the man immensely, making him lack the capacity to deliver at his workplace since he began underperforming in his duties at a local chemical company where he worked as a forklift operator. To relieve the situation, the patient has attempted to use Diphenhydramine to make himself fall asleep. Still, the effects of the medication have not been practical because of the way it made him feel the following day. The patient says that he has found himself falling asleep at the job place due to not having slept the previous night. Looking into his medical history, the patient once suffered from opiate abuse, which occurred due to a skiing accident that led to his ankle breaking. As a result, he was prescribed Hydrocodone and Acetaminophen to relieve pain. He has not received any medication for opiates in 4 years and has used alcohol to induce sleep. Finally, except of the recent trauma, there is no information in patient’s medical history about any other mental issues.

My selection in point one would be to use Tradozone 50mg Po at bedtime. This is because the medication is very helpful in treating the condition that the patient is suffering from. This medication is effective in treating depression, a condition that the patient may be going through due to the death of his girlfriend. The incident greatly affected him, which led to a lack of ability to sleep for six months (Wichniak et al., 2021). The medication works by improving the patient’s mood, increasing energy levels, and improving sleep quality by suppressing anxieties that may lead to insomnia.

The other two options were not selected because Zolpidem has adverse side effects that may worsen the patient’s condition. The negative aftereffects are headaches, lightheadedness, general body weakness, dizziness, drugged feeling, and imbalance while a person walks or stands. This means that it does not provide the best medication to the patient since the side effects are an equally significant disadvantage to the patient. On the other hand, Hydroxyzine has many side effects that negatively affect the patient’s health. The side effects include chest pains, discomfort, skin itching and rash, increased heart rate, shortness of breath, and eye problems. The selection of Tradozone was aimed at reducing the patient’s anxiety levels, which will reduce insomnia, leading the patient to a stable sleeping schedule. Ethical considerations in medication impact treatment because it affects the interaction between the patient and the doctor (Wichniak et al., 2021). Respect for the patient’s consent while administering treatment is crucial because it influences their attitude. Adherence to confidentiality in treatment reduces instances of the patient’s information becoming public.

The second decision was to reduce the dosage of Tradozone by half so that the patient uses 25 mg during bedtime to induce sleep. The prescription of 50mg of Tradozone made the patient complain of some side effects which may have been a result of an overdose. One of the side effects of the excessive prescription is an erection that lasts up to 15 minutes after waking up. This condition hindered and slowed down his work preparation because he could not comfortably go downstairs to have breakfast with his family. Suvorexant was not selected because has even worse side effects, such as: drowsiness, headache, drying of the mouth, coughing, dizziness, and unusual dreams (Campbell et al., 2020). In addition, the dosage of Tradozone was lowered because the condition will persist over time.

The dose reduction from 50mg to 25mg was chosen to reduce the side effects of the medication while still maintaining the treatment of the situation. Thus, by reducing the dose, the aim is to stop the 15-minute erection that the excessive usage of the drug may have caused. An overdose of Tradozone may have side effects that lead to priapism. Ethical considerations impact treatment in many ways, including the improvement of the patient’s attitude towards the medical provider. Consent is vital because it ensures the patient is aware of the ongoing processes in the treatment journey. In addition, another ethical practice is the practice of confidentiality which increases the privacy levels of the treatment process (Campbell et al., 2020). This improves the doctor-patient relationship as confidential information is protected.

The third decision is to continue giving the patient the 25mg of Tradozone every night before bedtime because the medication was effective since it helped him to sleep formerly. That is why the patient was encouraged to continue using the previous dose to improve sleep. Another recommendation at this stage is the adoption of sleeping hygiene. This involves sleeping at the right time and in the right environment with the right mental state. Tradozone was not replaced by Ramelteon because Tradozone has been effective in enabling the patient to sleep. Additionally, Ramelteon has side effects such as daytime drowsiness, dizziness, nausea, and even worse sleeping experiences, making it ineffective (Naono et al., 2018). Discontinuation of Tradozone and substitution with Hydroxyzine was not the best choice because it has side effects; chest pains, itching of the skin, increased heart rate, and breathing problems.

Tradozone was continued because it showed its significant efficiency in making the patient sleep. The dose should be maintained at 25mg every night before bedtime since increasing the dose will lead to side effects, one of them being priapism. The dose would achieve its purpose in helping the patient sleep every night, therefore avoiding insomnia that had been his case before. Ethical considerations in the choice to continue using Tradozone are very important. Confidentiality boosts the security of information on the health status of the patient and the medication, improving the conduct of medical care by the provider (Naono et al., 2018). Equally, ethical considerations protect the patient from inappropriate medication by considering the patient’s consent before administering the medication.

Conclusion

Therefore, in the case of treating the 31-year-old patient’s insomnia Tradozone was selected as the main medication because of the many advantages it provided to the patient and few disadvantages. In the first place, the institution of 50mg of Tradozone for insomnia treatment was very effective and helped patient to have normal night sleep. However, the 50mg of Tradozone turned out to be an overly high dose and may have amounted to an overdose. As a result, the patient suffered from priapism, which led to a 15-minute erection every morning after waking up (Vgontzas et al., 2019). The erection made the patient very uncomfortable, and as a consequence, he could not have breakfast with his family on time and was regularly late in his preparation for work.

After the patient complained about the medicine, the doctors reduced the dosage from 50mg to 25mg. The institution of the 25mg solved the problem of insomnia and stopped patient’s previous side effects. The patient could sleep without issues and without priapism which had disturbed him before. The doctors recommended that since the treatment made the patient recover from insomnia, the patient was to continue using the dose and adopt appropriate sleeping hygiene. Several other alternatives (Zolpidem and Hydroxyzine) were considered to treat the patient’s condition throughout the entire medication process. However, Zolpidem has many side effects, including headache, dizziness, general weakness, drugged feeling, and lightheadedness, making it ineffective. Hydroxyzine is not the best solution because it is associated with side effects of chest pains, increased heart rate, skin rash, and difficulty in breathing (Vgontzas et Al., 2019). Other medications have complications associated with the adverse aftereffects as well, making Tradozone the best remedy for insomnia. This is because Tradozone, when used appropriately in the correct dosage, works best in resolving insomnia.

References

Campbell, E. J., Marchant, N. J., & Lawrence, A. J. (2020). A sleeping giant: Suvorexant for the treatment of alcohol use disorder? Brain Research, 1731, 145902.

Naono-Nagatomo, K., Abe, H., Araki, R., Funahashi, H., Takeda, R., Taniguchi, H., & Ishida, Y. (2018). A survey of the effects of Ramelteon on Benzodiazepine-dependence: Comparison between a Ramelteon add-on group and a continuous Benzodiazepine administration group. Asian Journal of Psychiatry, 36, 20-24.

Vgontzas, A. N., Puzino, K., Fernandez-Mendoza, J., Krishnamurthy, V. B., Basta, M., & Bixler, E. O. (2020). Effects of trazodone versus cognitive-behavioral therapy in insomnia with short sleep duration phenotype: a preliminary study. Journal of Clinical Sleep Medicine, 16(12), 2009-2019.

Wichniak, A., Wierzbicka, A., & Jarema, M. (2021). Treatment of insomnia – effect of Trazodone and hypnotics on sleep. Psychiatria Polska, 55(4), 743-755.

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NursingBird. (2023, April 10). Medical Treatment of Alcohol Use Disorder. Retrieved from https://nursingbird.com/medical-treatment-of-alcohol-use-disorder/

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NursingBird. (2023, April 10). Medical Treatment of Alcohol Use Disorder. https://nursingbird.com/medical-treatment-of-alcohol-use-disorder/

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"Medical Treatment of Alcohol Use Disorder." NursingBird, 10 Apr. 2023, nursingbird.com/medical-treatment-of-alcohol-use-disorder/.

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NursingBird. (2023) 'Medical Treatment of Alcohol Use Disorder'. 10 April.

References

NursingBird. 2023. "Medical Treatment of Alcohol Use Disorder." April 10, 2023. https://nursingbird.com/medical-treatment-of-alcohol-use-disorder/.

1. NursingBird. "Medical Treatment of Alcohol Use Disorder." April 10, 2023. https://nursingbird.com/medical-treatment-of-alcohol-use-disorder/.


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NursingBird. "Medical Treatment of Alcohol Use Disorder." April 10, 2023. https://nursingbird.com/medical-treatment-of-alcohol-use-disorder/.