Our Services

Get 15% Discount on your First Order

[rank_math_breadcrumb]

De-Prescribing Psy meds

 

De-Prescribing and  taper from a medication safely or transition to a new medication 

De-Prescribing

What is the importance of de-prescribing? How might you assist a patient to taper from a medication safely or transition to a new medication?

In this Assignment, you will use the following patient examples to write a 5- to 6-page paper on considerations you have for how you might de-prescribe. Support your answers with five (5) evidence-based, peer-reviewed scholarly literature resources outside of Required Learning Resources in this course.

Note: APA style format guidelines will apply.

Patient Examples:

Patient 1: A 36-year-old male presents to your office being prescribed by his primary care physician (PCP) for the past 3 years an opioid analgesic medication for a work accident. He has chronic pain and is attending a pain clinic. It is determined the best course of treatment for pain is to remain on opioid medication. The patient is also being prescribed clonazepam 1mg BID for “relaxation” and panic attacks.

Patient 2: A 42-year-old female on alprazolam 1mg BID for panic attacks. Panic attacks have been in remission and the patient wants to taper off the medication. But, every time she has attempted to do so in the past, she experienced withdrawal effects. She is wondering how to safely taper off the benzodiazepine medication without having withdrawal effects.

Patient 3: A 24-year-old female prescribed lorazepam 1mg TID for generalized anxiety disorder. She recently found out she is pregnant (9 weeks gestation). She was referred to you by her OB-GYN to discuss this medication for her current situation. The patient is wondering if she can stay on the lorazepam through her pregnancy and postpartum, as it is an effective medication for anxiety symptoms. She plans to exclusively breastfeed for the first 6 months postpartum. She has not had any other trials of medication to treat anxiety as lorazepam has been effective.

Patient 4: A 71-year-old-male who comes to see you at the insistence of his daughter. His daughter expresses concern of memory loss and is wondering if he has the beginning stages of dementia. He is forgetful and seems to be tripping on things or walking into walls, although he has lived in the same home for the past 35 years. The patient does not agree with his daughter but does admit he has had a “few stumbles and falls” lately. Medication reconciliation shows the following medications: metoprolol ER 50mg q day, omeprazole 20mg q day, clonazepam 1mg TID, levothyroxine 75mcg q am. His daughter is wondering if he should be started on a “dementia medication.”

Answer the following questions using the patient examples described above.

Patient 1

· What are the concerns of the patient remaining on the opioid medication and clonazepam?

· How might you educate the patient about these risks and concerns?

The patient agrees that he should not continue both medications in combination. He would like to “get off” the clonazepam but worries about “bad withdrawals” that he’s heard about from stopping clonazepam “cold turkey” and is concerned about re-occurring panic attacks. How might you respond to the following:

· How would you instruct the patient to taper off clonazepam?

· What other medication would you recommend for the patient for the treatment of his panic attacks? Keep in mind, he will continue the opioid medication for pain relief.

· How would you start the new recommended psychotropic medication for the patient?

· Discuss one legal, ethical, or social consideration with the treatment plan.

Patient 2

· The patient reports withdrawal symptoms when previously tapering off the alprazolam. What symptoms are common withdrawal symptoms from this medication?

· Provide the patient education of withdrawal symptoms that range from common and less serious to withdrawal symptoms that are a cause for concern and that should prompt patient should seek medical attention.

· Given the patient’s history of having withdrawal effects from attempting to taper off alprazolam, what longer-acting benzodiazepine would you choose to convert the patient to?

· What is the dose you would prescribe and how would you taper off the medication?

Patient 3

· Review the potential risks, benefits, and side effects of continuing lorazepam throughout the pregnancy and postpartum for both the patient and fetus.

· Review other alternative medications to treat generalized anxiety disorder. Include risks, benefits, and potential side effects to both the patient and the developing fetus. Keep in mind, the patient is looking to breast feed for 6 months postpartum.

· The patient agrees that it would be safest for her pregnancy and fetus to discontinue the lorazepam. How would you recommend she discontinue lorazepam? Provide education on potential side effects from tapering off the medication, including common side effects to more serious side effects and when to seek medical attention.

· The patient would like to forgo medications at this time, given she is early in her pregnancy and is concerned about “damage” to the fetus if she were to continue medications. Provide education to the patient about the risks of untreated anxiety symptoms during pregnancy for both the patient and the fetus.

Patient 4

· Review potential side effects for elderly on benzodiazepines providing education to both the patient and the patient’s daughter. What are the risks of continuing the benzodiazepine for this patient?

· How would you evaluate the patient for these side effects?

· The patient and daughter agree he will need to taper off the clonazepam given the risks of continuing this medication. How would you recommend tapering off this medication?

· Review with the patient and daughter potential side effects of tapering off the medication. Review with them common side effects to more serious side effects and when to seek medical attention.

GRADING CRITERIA

Patient 1: Describes concerns for patient remaining on the medication and how these risks and concerns will be addressed to the patients. Describes how to assist Patient 1 in tapering medication, as well as what other medication might be prescribed with considerations of legal, ethical, or social considerations to the plan.

20 to >18.0 pts

Excellent

The response comprehensively describes medication risks and concerns. The response comprehensively and clearly explains how the patient will be educated. The response comprehensively and clearly explains considerations for medication tapering. The response comprehensively and clearly reflects on legal, ethical, or social considerations of the plan.

Patient 2: Describes common withdrawal symptoms and patient education information. Describes which benzodiazepine might be prescribed to convert the patient, as well as the specific dosing and tapering information.

20 to >18.0 pts

Excellent

The response comprehensively and clearly explains withdrawal symptoms. The response comprehensively and clearly provides patient education information. The response comprehensively and clearly identifies a benzodiazepine for the patient. The response comprehensively and clearly details dosing and tapering information.

Patient 3: Describes potential risks, benefits and side effects of lorazepam, as well as alternative medications that might be prescribed for the patient. Describes how the patient might discontinue lorazepam, with necessary patient education regarding discontinuing medication and patient/fetus needs.

20 to >18.0 pts

Excellent

The response comprehensively and clearly describes risks, benefits and side effects of lorazepam. The response comprehensively and clearly identifies potential alternative medications. The response comprehensively and clearly describes how the patient might discontinue the medication. The response comprehensively and clearly provides necessary education for discontinuing the medication for patient and fetus.

Patient 4: Describes potential risks and side effects of continuing benzodiazepine. Describes how to taper the medication and education regarding the tapering.

20 to >18.0 pts

Excellent

The response comprehensively and clearly describes potential side effects and risks. The response comprehensively and clearly describes how to taper the medication. The response comprehensively and clearly provides necessary patient education for tapering.

Paper demonstrates critical thinking and synthesis of literature with five (5) evidence-based, peer reviewed scholarly references

5 to >4.0 pts

Excellent

Paper demonstrates critical thinking and synthesis of literature with five (5) evidence-based, peer reviewed scholarly references outside of course resources.

Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteri

Share This Post

Email
WhatsApp
Facebook
Twitter
LinkedIn
Pinterest
Reddit

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

PRACTICUM EXPERIENCE PLAN (PEP)- 6675

TO PREPARE Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?   Review the information related to

PRACTICUM EXPERIENCE PLAN (PEP)- 6665

Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?   Review the information related to developing objectives

Asssigment part 2 part one attached

Use Rubric Health Care Delivery Models and Nursing Practice Start Date Sep 1, 2025, 12:00 AM Due Date Sep 7, 2025, 11:59 PM Points 165 Rubric View Rubric Status Active Assessment Traits Requires Lopeswrite Assessment Description Examine changes introduced to reform or restructure the U.S. health care delivery system. In

appendix H: synthesis and recommendations tool

 appendix H: synthesis and recommendations tool “Synthesis is where you take multiple pieces of evidence or multiple sources and their ideas and you talk about the connections between those ideas or those sources. “ – OASIS (2016, transcript para. 3) Evidence synthesis is defined as a step and method used to

Family Assessment

  About “Mother and Daughter: A Cultural Tale”  Therapist Gonzalo Bacigalupe (Thousand Oaks, CA: Masterswork Productions, 2003), 1 hour 16 minutes  An interview with an Irani immigrant mother and her 23 year old daughter highlights the difference that their cultural lenses create in their mutual expectations. Very typical of children becoming Americanized, the daughter wants

Behavioral Health Assessment & Diagnostic course

Thinking about what you’ve learned in Behavioral Health Assessment & Diagnostic course   1-    If you had the power to change anything in this class that is assessment related, what would you change and why? 2-    How will the concepts you learned in this class help you in your career?

NUR 620

Discussion Week 2 200 word each response 1. Reply from Kelly Zukowski NUR 620 Discussion Posting Two Describe the three reasons it is important to gather detailed and extensive information from any patient before you counsel him/her or make medical suggestions. Use evidence-based research to support your position. The first

Pertinent Healthcare Issue

help for assignment infomation down below in attachement To Prepare: · Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study. · Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor

nur509cl discussion two

Please write this discussion post based on a 60-year-old African American male with bilateral upper arm pain. Patient has a history of GERD, HLD, and CHF.

Nursing policy week 4 assignment

Please see attached  To Prepare: Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources. The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement) Be sure to add a title page, an introduction, purpose statement, and

nursing

  Respond to at least two colleagues on two different days in one or more of the following ways: Ask a probing question, substantiated with additional background information, evidence, or research. Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. Offer and support

nursing

Read a selection of your colleagues’ posts and respond to at least two of your colleagues on two different days by supporting or expanding on the ideas identified by your colleague or sharing additional perspectives on the population, advocacy priorities, and/or policies described by your colleague.

Research Topic

Identify a Clinical Phenomenon of Interest Reflect on your individual and group clinical experiences. Select a problem or issue that is meaningful, observable in practice, and worthy of study. Clarify the Topic Research the selected phenomenon of interest using current literature. Discuss the significance of this issue in nursing practice. Define

Nursing HOMEWORK

Master of Science in Nursing   Practicum Experience Plan Overview: Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and

Asssigment

Week 1 assignment Completion requirements Opened: Monday, September 1, 2025, 12:00 AM Due: Saturday, September 6, 2025, 11:59 PM Define cultural competence. Explain the importance of Cultural competence in our profession. Provide examples  Rubric: 3 pages – 5 pages maximum including title page and references -APA format including references -At Leat 3

1 soap note

1 NU610 Unit 1 Case Study A 19-year-old female presents with a complaint of headaches frequently. She reports that she has had them since she was a teenager, but they have become more debilitating recently. The episodes occur once or twice a month and last for up to 2 days.