Case Study Analysis: A Caucasian Man With Hip Pain
Introduction
Our study case relates to a patient is diagnosed with complex pain disorder (reflex sympathetic dystrophy). Reflex sympathetic dystrophy is a condition that causes lasting pain on the legs or arms mainly after an injury, stroke. However, since the pain is from tissue injury, it's not related in any way to nerve damage. This condition is as a result of problems associated with the sympathetic nervous system that assist in blood flow movement regulating blood pressure and heartbeat rate. When the system gets mixed signals, it may end up turning on after an injury but later doesn't turn off and this causes a lot of pain and swelling at times. Some of the symptoms that indicate complex pain disorder are pains that get worse every time after the injury. Such injuries may include fractures, burns, sprains, minor surgery among others. Areas in the body that are commonly affected with this condition are hips, legs, arms, and the shoulders. This pain continues to spread on other areas other than the injury site. Pains that may he will experience are aching in the place, cold and burning sensations. It's because of this that you may find the patient having stiff joints, muscle weaknesses and trouble moving affected areas.
In this study, we are required to give decisions on medication of the client considering pharmacokinetic and pharmacodynamics processes. We are also to give reasons for the choice of such medicines. Lastly, we are expected to include ethical considerations impacting treatment plans and communication with the client.
Decision 1. I prescribed Savella 1205mg in the first day of treatment; followed by 12. 5 mg BID on day two and three. 25mg of BID on day 4-7. 50 mg BID after that. The prescription decision was due to factors such as the constant pain that the client faced in his hip and this drugs. The drug helps treat chronic pain that the client is experiencing. By administering this drugs, I expected that the medicines would suppress the pain that the client is facing and at least some relief to the client. I hoped that the patient would well respond to the drugs and with time walk with no strain and do away with the crutches. The client came back to the hospital without crutches but limping. This means that the pain was now manageable. However, the patient complains of sweating without reason, sleeping problems and high pumping rate of blood felt in the chest. There was quite some difference between the results and what expectation. These differences came along with the side effects associated with the drug. The stated side effects were common side effects of the Savella drug.
Decision 2. The patient is supposed to go on with the current medication but at a lower dose of 25mg twice a day. This decision was due to the results in the previous description. The patient seemed not to accommodate higher dosage which led to adverse side effects of the drug. By making this prescription, I hope that the client will adequately respond to the medication and reduce the side effects affecting the client. It was also my hope that the drug will still suppress the pain, therefore, improving the condition of the client. However, the patient returned to the hospital with crutches complaining of the increased pain. He now sleeps at night, but he is woken up by pains experienced. The heart rate of the patient now had at least gone down. There was a difference in the response due to the reduced dosage. The pain was too much to be suppressed by the small dose. But then, some of the side effects were now minimal due to the reduced dosage.
Decision 3. I prescribed a change of Savella to 25mg orally in the morning and 50mg orally at bedtime. This prescription this prescription is to work in a way as to suppress the pain while at the same time focus on reducing the effect of the drug on the patient. I hope that the patient will respond to this and thus soon do away with the crutches as the pain will suppress. Also, the side effects of the drugs should have less impact on the patient. He should be able to sleep well, not sweating for no reason and should not be having the feeling of nausea. However, the client did not respond to this pain medication. The results were more similar to the first and second decision. This might be the case because we might be treating the wrong condition since the drug was not responding well with the patient. This meant that the client had a complex neuropathic pain syndrome which may never respond to the kind of medicine administered.
Upon consultation, I had engaged the client into a conversation trying to make him understand that the pain levels expectations needed to be realistic and that he will always experience some level of pain on a daily basis. However, this can be minimized enabling him to continue with his daily activities with little discomfort. I recommended physical therapy, heat and massage therapy along with the medicine. The medications prescribed in this case as a reduction of Savella drug dose during parts of the day that it pain is under more control. Also and attrition of the Celexa drugs which will work in hand with Savella.
Ethical considerations might impact the treatment plan and communication with the client as the clients tend to respect decisions made by you and by this following the correct dosage and the recommendations of the doctors. In this case, improvements of clients’ conditions is recorded at high rates.
Conclusion
Above, we have discussed the case study of a Caucasian man with the hip pain. We have talked of prescriptions given and seen the positive and negative responses. A way forward is found on how to make a decision considering the previous choices and results. We have also noticed that medication may also need other factors such as physical therapy to expect positive results. Lastly, we looked at how ethical considerations might impact the treatment plan of clients and noted that clients tend to respect decisions made by you and by this following the correct dosage and the recommendations of the doctors.
