NURS_6630 Understanding and Management of Various Psychiatric Disorders Essay

NURS_6630 Understanding and Management of Various Psychiatric Disorders Essay

NURS_6630 Understanding and Management of Various Psychiatric Disorders Essay

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?

The appropriate pharmacotherapy for a patient with MDD and a history of alcohol abuse will include a combination of antidepressants like Selective serotonin reuptake inhibitors (SSRIs) and dependence medication like Naltrexone or Acamprosate. Alsheikh et al. (2020) found that a combination of Sertraline (an SSRI) with naltrexone to treat alcohol dependence led to higher alcohol discontinuation rates and a marked decrease in depression symptoms, with tolerable side effects. Tricyclic antidepressants (TCAs) are contraindicated in persons with a history of alcohol abuse since they increase the risk of toxicity and alcohol’s depressant effect on the CNS (Alsheikh et al., 2020). An improvement in MDD symptoms is expected within 2-6 weeks of Sertraline and Naltrexone therapy as long as there is medication adherence.

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2. List 4 predictors of late onset generalized anxiety disorder.

The factors associated with late-onset GAD include health, disability of self or spouse, finances, and female sex. Elderly persons with chronic health conditions have an increased risk of developing GAD. Besides, those with a disability or incapacitated spouses are likely to develop GAD later in life (Welzel et al., 2021). Inadequate finances, especially for retirees, make older adults vulnerable to GAD. Furthermore, females have a higher risk of developing late-onset GAD than men.

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

The neurobiology causes of psychotic major depression include abnormalities in neurotransmitters, HPA axis, increased inflammation, and structural abnormalities. Depression is associated with serotonergic, dopaminergic, noradrenergic, and glutamatergic systems abnormalities. Reduced levels of serotonin and norepinephrine and increased glutamate levels are linked with depression (Li et al., 2021). Abnormalities in the HPA axis related to depression include hypersecretion of Corticotropin-releasing hormone (CRH) by the hypothalamus, Hypercortisolemia secondary to a hypersensitive HPA axis, uncontrolled negative feedback regulation of CRH. Furthermore, inflammatory conditions increase the risk of depression, with patients having elevated levels of inflammatory biomarkers, like C-reactive protein, interleukin, and tumor necrosis factor-alpha (Li et al., 2021). Alterations in the brain structure are associated with depression, including abnormalities in the dorsal and ventral anterior cingulate cortex, the dorsal and medial prefrontal cortex, the orbital frontal cortex, and the insula.

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.

The diagnostic criteria for major depression require the presence of either a depressed/sad/tearful mood or diminished pleasure/interest in activities. In addition, the diagnosis requires at least four of the following symptoms: appetite changes, weight changes, fatigue or low energy levels, insomnia or hypersomnia, feelings of inappropriate guilt or worthlessness, psychomotor retardation or agitation, shed ability to concentrate and make decisions, and suicidal thoughts, ideations, or plans (Li et al., 2021).

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

Various drug classes can potentially interrupt sleep and waking function because of their pharmacologic effects on the numerous receptors and neurotransmitters associated with sleep-wake regulation (Van Gastel, 2018). They include Loop diuretics like Furosemide, Angiotensin Receptor Blockers like Losartan, and Alpha-1 Antagonists like Prazosin.

References

Alsheikh, A. M., Elemam, M. O., & El-Bahnasawi, M. (2020). Treatment of depression with alcohol and substance dependence: A systematic review. Cureus, 12(10). DOI: 10.7759/cureus.11168

Li, Z., Ruan, M., Chen, J., & Fang, Y. (2021). Major Depressive Disorder: Advances in Neuroscience Research and Translational Applications. Neuroscience bulletin, 37(6), 863–880. https://doi.org/10.1007/s12264-021-00638-3

Van Gastel, A. (2018). Drug-Induced Insomnia and Excessive Sleepiness. Sleep medicine clinics, 13(2), 147–159. https://doi.org/10.1016/j.jsmc.2018.02.001

Welzel, F. D., Luppa, M., Pabst, A., Pentzek, M., Fuchs, A., Weeg, D., … & Riedel-Heller, S. G. (2021). Incidence of Anxiety in Latest Life and Risk Factors. Results of the AgeCoDe/AgeQualiDe Study. International Journal of Environmental Research and Public Health, 18(23), 12786. doi: 10.3390/ijerph182312786

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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.

NURS_6630_Week8_Assignment1_Rubric

NURS_6630_Week8_Assignment1_Rubric

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 it is the timeframe that the patient should see resolution of symptoms?13 to >11.0 pts

Excellent Point range: 90–100

The response accurately and clearly explains in detail the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse…. The response accurately and clearly details which drugs are contraindicated with specific examples…. The response accurately and clearly explains in detail the timeframe that the patient should see resolution of symptoms.

13 pts

This criterion is linked to a Learning Outcome

List four predictors of late onset generalized anxiety disorder.13 to >11.0 pts

Excellent Point range: 90–100

The response accurately and clearly lists in detail four predictors of late-onset generalized anxiety disorder.

11 to >10.0 pts

Good Point range: 80–89

The response accurately lists four predictors of late-onset generalized anxiety disorder.

10 to >9.0 pts

Fair Point range: 70–79

The response inaccurately or vaguely lists four predictors of late-onset generalized anxiety disorder.

9 to >0 pts

Poor Point range: 0–69

The response inaccurately and vaguely lists four predictors of late-onset generalized anxiety disorder, or is missing. 13 pts

List four potential neurobiology causes of psychotic major depression.13 to >11.0 pts

Excellent Point range: 90–100

The response accurately and clearly lists in detail four potential neurobiology causes of psychotic major depression.13 pts

An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least five symptoms required for the episode to occur. Be specific.13 to >11.0 pts

Excellent Point range: 90–100

The response accurately and clearly explains in detail at least five symptoms for the episode of major depression to occur…. Specific examples provided fully support the response. 13 pts

List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.13 to >11.0 pts

Excellent Point range: 90–100

The response accurately and clearly lists in detail 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia…. Examples provided fully support the response provided.

13 pts

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation5 to >4.0 pts

Excellent Point range: 90–100

Uses correct grammar, spelling, and punctuation with no errors. 5pts

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.5 to >4.0 pts

Excellent Point range: 90–100

Uses correct APA format with no errors.

5 pts

Total Points : 75