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

Introduction Primarily, addiction disorders, characterized by a lack of impulse control, often coexist with impulse and compulsivity disorders. Drug addiction is typically linked to difficulties with obsessive and compulsive conduct (Goslar et al., 2018). The patient in this case presentation is 53 years old and has been plagued with an unsightly addiction for an extended period. The patient acknowledges that she had struggled with alcoholism since her father's death as a teenager. With the proximity of a new casino in her neighborhood, she says she has had trouble maintaining sobriety. Typically, the excitement after gambling drives her to take alcohol. She also said that she prefers to drink during big stakes games to help her relax. She admits that she has difficulty controlling her gambling and drinking habits. Furthermore, she admits that she has increased her smoking during the previous two years and is worried about possibly devastating impacts. She has gained seven pounds since her last weigh-in, signifying a tremendous increase in weight. At the moment, the patient is worried concerning a loan that she took to repay debts that have accrued due to gambling. Essentially, she took a loan of $50,000 from her retirement scheme. Her mental status assessment results reveal that she has poor impulse control, avoids eye contact, and has a depressed mood. The patient is ultimately diagnosed with alcoholism and gambling addiction. Typically, the patient's circumstances influence the doctor's decision-making when prescribing medicine. Gambling and alcoholism are two examples of comorbid disorders that are usually challenging to diagnose. Pharmacological interventions, including other therapeutic options, may impact the treatment process. Drugs are prescribed based on the patient's age, weight, and other health-related criteria. The fundamental goal of this case study is to make three judgments about the best pharmacological treatment for the patient and the GRADED A+ 3 justification for each option. Moreover, the paper will highlight the ethical issues that may impact the treatment plan and how to communicate effectively with the patient. Decision # 1: Vivitrol (Naltrexone) injection, 350 mg intramuscular in the gluteal region every 4 weeks At this point, the most appropriate decision is to begin a 380 mg intramuscular injection of Naltrexone in the gluteal area every four weeks. Naltrexone, FDA-approved medication for alcohol dependency, is effective in raising the odds of achieving complete abstinence from alcohol and lowering excessive drinking, in addition to reducing the intensity of cravings to gamble and gambling thoughts and behavior (Naltrexone, 2018). Naltrexone work by inhibiting opiate receptors in the brain, thus reducing alcohol cravings (Naltrexone, 2018). Vivitrol has been approved as the preferred option since it is given monthly (Naltrexone, 2018). This approach of administering once a month promotes patient compliance and adherence to the medication process. Most important is that Naltrexone tends to reduce nicotine cravings. Antabuse (Disulfiram) 250 mg is not the best option for this patient since the patient is at risk of taking alcohol while undergoing treatment. Given that alcohol consumption should be avoided for 12 to 24 hours before commencing Antabuse (Disulfiram) 250 mg once a day may lead to adverse side effects when taken with alcohol. This alternative is thus not recommended ("FDA Approves Lofexidine, Drug That May Ease Vivitrol Induction," 2018). When Antabuse is consumed alongside alcohol, it causes an irreversible inhibitor of aldehyde dehydrogenase to build up ("FDA Approves Lofexidine, Drug That May Ease Vivitrol Induction," 2018). This might cause unpleasant side effects such as nausea, vomiting, and hypotension, making it challenging to adhere to medication. On the other hand, Campral (acamprosate) 666 mg orally is another unsuitable option for this patient. Typically, when issued to people with obsessive