NURS 6630 Short Answer Assessment Paper

NURS 6630 Short Answer Assessment Paper

NURS 6630 Short Answer Assessment Paper

NURS 6630 Short Answer Assessment

 Short Answer Assessment

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 the resolution of symptoms?

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According to Anker (2019), recent findings from controlled trials suggest that a combination of antidepressants, such as sertraline, and naltrexone, a medication used for alcohol treatment, represents the most efficacious treatment approach for individuals experiencing comorbid depression and alcohol dependence. Individuals classified as Type A alcoholics may derive significant benefits from selective serotonin reuptake inhibitor (SSRI) therapy due to their comparatively lower levels of acute distress and later onset of alcohol dependence (McHugh & Weiss, 2019).

According to Thom et al. (2019), the administration of sertraline and naltrexone in conjunction resulted in the complete eradication of depressive symptoms and alcohol consumption among patients within a timeframe of 8 to 12 weeks. Notably, a notable amelioration in symptoms was observed during the initial four weeks of treatment. The use of antidepressants with a potential for overdoses, such as nortriptyline, duloxetine, or bupropion, is contraindicated in individuals with a comorbidity of depression and alcohol use disorder due to the increased risk of suicide associated with these medications.

1. List 4 predictors of late-onset generalized anxiety disorder.

• Being female: According to recent studies, it has been discovered that females exhibit heightened sensitivity to low concentrations of corticotropin-releasing factor (CRF), a hormone responsible for regulating stress responses in mammals. This heightened sensitivity renders women twice as susceptible as men to the development of stress-related disorders (Park & Zarate, 2019).
• A recent occurrence of a life-adverse event.
• The presence of physical illnesses that persist throughout time such as heart failure, arrhythmia, breathing problems, and dyslipidemia, among others, has been identified as potential predictors of late-onset generalized anxiety disorder.
• A history of mental illnesses such as GAD, phobias, and depression (Park & Zarate, 2019).

1. List 4 potential neurobiology causes of psychotic major depression.

• Hypersensitive to stress: The role of stress in the initiation and intensification of positive symptoms of psychosis has been consistently implicated. There is a growing body of interest surrounding the examination of the impact of psychosocial stress on the manifestation of psychosis symptoms in individuals who are identified as being at Clinical High Risk (CHR) for psychosis (Thom et al., 2019).
• Serotonin deficiency: Numerous studies have established a correlation between a deficit in serotonin levels and the manifestation of depression, as well as the potential association with various other disorders. Pharmaceutical substances that enhance serotonin levels or modulate its activity, such as SSRIs, have demonstrated efficacy in the management of depression, anxiety, migraine, and various other medical conditions (Thom et al., 2019).
• Propensity for major depressive disorder: Depression is a psychiatric condition that may lead to the occurrence of psychotic episodes, particularly in cases where individuals do not have access to adequate professional care and treatment(Thom et al., 2019). Co-occurrence of mood disorders and psychotic disorders is feasible; however, it is important to note that depressive disorders should be regarded as separate entities from schizophrenia.
• Higher amounts of dopamine:According to Thom et al. (2019), there is a consensus among researchers regarding the significant involvement of dopamine in the manifestation of psychosis. Dopamine is classified as a neurotransmitter, which is one of several chemical substances employed by the brain to facilitate the transmission of information between individual neurons. It is linked to individuals’ subjective perception of the significance, importance, or interest of something.

1. An episode of major depression is defined as a period lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.

• A decrease in physical or mental energy or the state of being tired.
• Anhedonia
• Depression
• Difficulties with sleep
• A sense of diminished self-worth (Li et al., 2021).

1. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific. 

• Dopamine agonists, such as pramipexole and apomorphine, are pharmaceutical interventions commonly employed in the management of Parkinson’s disease (Li et al., 2021). The consumption of these substances heightens the likelihood of experiencing hallucinations, which in turn can lead to disruptions in sleep patterns. Motor fluctuations, such as the occurrence of “off” periods due to medication, can also contribute to sleep disturbances.
• Selective serotonin reuptake inhibitors (SSRIs), such as sertraline and fluoxetine (commonly known as Prozac), are pharmacological agents commonly used in the treatment of various psychiatric disorders. According to Li et al. (2021), antidepressants that enhance serotonin function through the mechanisms of reuptake inhibition or metabolism inhibition exhibit the most pronounced impact on rapid eye movement (REM) sleep.
• Decongestants and cold medications, like oxymetazoline and phenylephrine, are commonly used to alleviate symptoms associated with nasal congestion. A number of these products comprise constituents such as pseudoephedrine or phenylephrine, which have the potential to induce a stimulatory response in certain individuals affecting their sleep.
  

References

Anker, J. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging the Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol Research: Current Reviews, 40(1). https://doi.org/10.35946/arcr.v40.1.03

Li, Z., Ruan, M., Chen, J., & Fang, Y. (2021). Major Depressive Disorder: Advances in Neuroscience Research and Translational Applications. Neuroscience Bulletin, 37(6). https://doi.org/10.1007/s12264-021-00638-3

McHugh, R. K., & Weiss, R. D. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, 40(1). https://doi.org/10.35946/arcr.v40.1.01

Park, L. T., & Zarate Jr, C. A. (2019). Depression in the primary care setting. New England Journal of Medicine, 380(6), 559-568.DOI: 10.1056/NEJMcp1712493

Thom, R., Silbersweig, D. A., & Boland, R. J. (2019). Major depressive disorder in medical illness: a review of assessment, prevalence, and treatment options. Psychosomatic Medicine, 81(3), 246-255.DOI: 10.1097/PSY.0000000000000678‌

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Short Answer Assessment

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.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare

Review the Learning Resources for this week.

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.

To complete:

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

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?

List 4 predictors of late onset generalized anxiety disorder.

List 4 potential neurobiology causes of psychotic major depression.

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.

List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

By Day 7

This Assignment is due.

submission information

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