Psychopharmacology treatment for Alzheimer's disease in elderly patients

Psychopharmacology Treatment for Alzheimers Disease

The purpose of this paper is to evaluate the three treatment options for Mr. Akkad suffering from Alzheimer's disease. Mr. Akkad is a 76-year Iranian patient demonstrating some strange behaviors. The patient has started losing interest in the major religious activities, which is critical for a member of the family. Moreover, he has started abandoning things he uses to take very seriously before, and these things have become sources of amusement and ridicule. Moreover, Mr. Akkad has been forgetting things within the past two years, and the issue seems to be getting worse. After clinical examination, Mr. Akkad scores 18 out of 30 revealing that the patient is suffering from moderate dementia based on his primary deficit in attention, registration, orientation, recall and calculation. However, Decision 1, Decision 2 and Decision 3 options are recommended for the treatment of Mr. Akkad.

The purpose of this paper is to evaluate the Decision 1, Decision 2 and Decision 3 for the treatment of the patient.

Choice for DECISION POINT ONE

This paper chooses the DECISION POINT ONE after evaluation of the results. Based on the analysis of the results of the Decision One, the patient is still disinterested in religious activities and services. Moreover, the patient still exhibits disinhibited behaviors. Despite administering Exelon (rivastigmine) 1.5 mg orally at bedtime within 2 weeks, the patient still scores 18 out of 30 with primary deficits in registration, orientation, recall, calculation and attention. The reason for the choice of the Decision One is that the medication given to the patient is good, however, the major reason patient has not yet recovered is that four weeks are too short to remark any positive changes from taking the medication. Definitely, the patient will recover from the disease if taking the drug for a longer period. One of the factors that make the patient not responding totally to treatment is an advance in ages. Elderly is defined as people aged from 65 years of age or older. Mangoni, and Jackson argue that advancing in age has been characterized by impairment in organs that may result in failure to maintain homeostasis under physiological stress. The authors further maintain that important pharmacodynamics and pharmacokinetic changes occur as an individual advance in ages. (Mangoni, and Jackson, 6). Midlov also argues that "pharmacotherapy in the elderly is one of the most challenging aspects of patient care" (1), thus, it is critical to understand and analyze the pharmacological properties of drugs before prescribing them for elderly patients. Essentially, different aspects of pharmacokinetics that include metabolisms, distribution, as well as real elimination are affected by age. Thus, elderly people are at greater risks of being adverse to drugs. The authors advise that it is critical to adjust in a choice of dosage and drugs for elderly people by starting with a low dosage and carefully evaluating the drug effect. To minimize the risks of drug adverse effects, it is critical to start with the lowest dosage that is required for the clinical effect. Since drugs are primarily tested among younger healthy people, thus, adverse drug reactions are more serious and frequent among the older adults. Thus, the choice of Decision One is based on the fact that the patient is likely to get better if the medication is prolonged after four weeks.

Choice for DECISION POINT TWO

The study chooses the Decision Two because the medication is ameliorating the symptom of the disease making the patient to becoming better. Based on the medication recommended, the patient is required to increase Aricept to 10mg orally at bedtime. The result of Decision 2 shows that the client is responding to the treatment after two weeks of taking the drugs. Compared to the Decision One, Decision 2 is better. Despite being tolerating to medication, and the client has started attending the church services, although the patient still amuses with things formerly taking very serious. The results of the Decision 2 reveals that the option will be a viable option for the patient if the patient continues taking the medication.

Ethical Consideration

The ethical issue is that the investigator uses the real name of the patient in the case, which is contrary to the ethical consideration. Typically, the investigator ought to have used the non-identifiable name in the case to protect the private information of the client. Moreover, the ethical consideration of the using different procedures to treat a patient show that the treatment procedure is not normal. By using different procedures for the treatment of the patients make this study to treat the patient as an instrument of the experiment. Thus, the investigator needs to seek approval from the patient before using the Decision One, Decision Two and Decision Three to treat the patient at the same time. The investigator also needs to seek approval from ethical review board before carrying out the experiment.