Psychopharmacologic treatments

As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

To prepare

· Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.

· Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

  1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
  2. List 4 predictors of late onset generalized anxiety disorder.
  3. List 4 potential neurobiology causes of psychotic major depression.
  4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
  5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

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Sample Answer

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  • Appropriate drug therapy for a patient with MDD and a history of alcohol abuse

The appropriate drug therapy for a patient with MDD and a history of alcohol abuse will depend on the individual patient’s specific symptoms and medical history. However, some general guidelines can be followed.

First, it is important to avoid medications that can interact negatively with alcohol, such as monoamine oxidase inhibitors (MAOIs). MAOIs can cause a serious reaction called serotonin syndrome when taken with alcohol.

Second, it is important to choose medications that are less likely to be abused. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are generally considered to be less addictive than other types of antidepressants.

Full Answer Section

Third, it is important to start with a low dose of medication and gradually increase the dose as needed. This will help to minimize side effects and reduce the risk of overdose.

The patient should see resolution of symptoms within 4-6 weeks of starting medication. If the patient does not see improvement after 6 weeks, the medication may need to be changed or the dose may need to be increased.

  • Contraindicated drugs for patients with MDD and a history of alcohol abuse

The following drugs are contraindicated for patients with MDD and a history of alcohol abuse:

  • MAOIs
  • Tricyclic antidepressants
  • Bupropion

These drugs can interact negatively with alcohol and can cause serious side effects.

  • Predictors of late onset generalized anxiety disorder

The following are four predictors of late onset generalized anxiety disorder (GAD):

  • Female gender
  • Family history of anxiety disorders
  • History of trauma or abuse
  • Medical conditions that can cause anxiety, such as hyperthyroidism or heart disease
  • Potential neurobiology causes of psychotic major depression

The following are four potential neurobiology causes of psychotic major depression:

  • Decreased levels of serotonin and norepinephrine
  • Increased levels of glutamate
  • Decreased activity of the hippocampus
  • Increased activity of the amygdala
  • Symptoms required for an episode of major depression

An episode of major depression is defined as a period of time lasting at least 2 weeks. The following are five symptoms required for the episode to occur:

  • Depressed mood
  • Loss of interest or pleasure in activities
  • Significant weight loss or gain (not due to dieting)
  • Insomnia or hypersomnia
  • Fatigue or loss of energy
  • Worthlessness or guilt
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death or suicide
  • Classes of drugs that precipitate insomnia

The following are three classes of drugs that can precipitate insomnia:

  • Stimulants
  • Antidepressants
  • Beta-blockers

Stimulants can interfere with sleep by increasing alertness and making it difficult to fall asleep. Antidepressants can also interfere with sleep, especially in the first few weeks of treatment. Beta-blockers can cause vivid dreams and nightmares, which can make it difficult to sleep.

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