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Summary Pharmacology Assignment.
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The patient is a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt ...

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  • June 10, 2021
  • 6
  • 2020/2021
  • Summary

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Case Study: A Caucasian Man with Hip Pain

Name

University

NURS 6521

Date

, Introduction


“The patient is a 43-year-old white male presents at the office with a chief complaint

of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical

interview, the client reports that his family doctor sent him for psychiatric assessment because

the doctor felt that the pain was “all in his head.” He further reports that his physician

believes he is just making stuff up to get “narcotics to get high.” The client asserts that the

pain began approximately seven years ago after sustaining a fall at work. During the fall, the

patient landed on the right hip. He reports that he does get “down in the dumps” from time to

time when he sees how his life has turned out, but emphatically denies depression.” The

mental examination shows that the client is oriented, alert and appropriately addressed for the

time and weather. He makes good eye contact with a clear speech. He denies any form of

homicidal or suicidal ideation.


Decision Step 1


During the first step, I would start this current patient on a dose of Amitriptyline 25mg

po QHS and titrate upward weekly by 25g to a max dose of 200mg per day. According to

Stahl (2013), Amitriptyline is serotonin and noradrenaline reuptake inhibitor that is effective

in the treatment of fibromyalgia, neuropathic pain, chronic pain and other pain syndromes.

The drug deactivates the beta adrenergic receptors and serotonin 1A by boosting the serotonin

neurotransmitters and norepinephrine (Stahl, 2013). Starting the current patient on Savella

was not chosen since the drug is a selective serotonin-norepinephrine reuptake inhibitor

(SNRI) which has the same compounds as those used in the management of psychiatric

disorders such as depression (Stahl, 2013). Savella may also be utilized for the treatment

fibromyalgia. However based on the chronic pain in the hip, I did not see the essence of

starting the current patient of drugs used for treatment of the psychiatric disorders (Arcangelo

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