Nursing

To Prepare
Review this week’s interactive media pieces and select one to focus on for this Discussion.
Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.

 ANSWER

Week 8 Discussion

Depression and the Types of Drugs that are Utilized for Treatment

Psychological disorders affect many individuals, including emotional and physical health. A psychological disorder can have severe impacts on job performance, relationships, and judgments. Psychological disorders affect the quality of life of all patients at all ages. Generalized anxiety disorder is characterized by excessive and persistent worry about a number of different issues (Robichaud, Koerner and Dugas, 2019). People that have generalized anxiety disorders have anticipated disaster or are overly concern about health, money, career job, family and other issues. As an advanced nurse practitioner, it is important to identify the patient’s symptoms and signs as well as the level of severity of the disorder, effective and safe diagnosis, as well as the most appropriate treatment plan for the patients. Anxiety can be moderated through treatment which makes them to function socially and have meaningful lives.

Case Study

For the case study, General anxiety disorder was chosen. The case involved a 46-year-old male who works at a local steel fabrication factory. The man complained of shortness of breath, chest tightens, feeling of impending doom and has some mild hypertension and is overweight. He admits that he has problems with the chest and periods of shortness of breath which he considers as anxiety attacks.

Decision Point One: Begin Zoloft 50 mg po daily

With the kind of rating, Sertraline, which is a selective serotonin reuptake inhibitor, would assist in managing the symptoms of anxiety. Ideally, individualized care is aimed at lowering the severity of the symptoms (Miller et al., 2014). Varying pharmacological treatments assist in treating anxiety, which includes selective serotonin reuptake inhibitors (Melaragno, Spera and Bui, 2020) The medications work through boosting the serotonin levels in the brain. Ideally, the inhibition of the reuptake of the neurotransmitter raises its levels, a feature that facilitates the therapeutic drug effects.

Decision Point Two: Use of SSRIs

The client returned to the clinic after four weeks and informed the nurse practitioner that he had no tightness in chest or shortness of breath. The client also stated that he had noticed decreased worries about 4 to 5 days ago. The anxiety score had decreased from 26 to 18 which indicated a partial response. Therefore, due to the positive side effects show by the client the dosage will be increased to 75mg orally daily. This will be essential in reducing the symptoms since earlier treatment has helped in reducing the patient’s anxiety disorder.

Decision Point Three: Maintain the Current Dose

The client returned to the clinic four weeks later and reported even a further reduction in his symptoms. The HAM-A score lowered to 10 which means that the current dose was able to reduce the symptoms by 61%.  Therefore, due to the positive side effects by the patient, the client will maintain the current dose. However, careful monitoring and titration of side effects will be essential in ensuring that drugs do not lead to hostile impacts.

Current theories link the changes to varying utilization and absorption of drugs among clients, owing to the changed biological structure due to age variation. However, tolerance rates may vary and hence the importance of precise monitoring and titration to avoid possible adverse impacts from the medications. Significant measures comprise of monitoring side effects, careful titration, patient education, and Treatment adherence to promote medication.

References

Melaragno, A., Spera, V., & Bui, E. (2020). Psychopharmacology of Anxiety Disorders. In Clinical Handbook of Anxiety Disorders (pp. 251-267). Humana, Cham.

Miller, M., Pate, V., Swanson, S. A., Azrael, D., White, A., & Stürmer, T. (2014). Antidepressant class, age, and the risk of deliberate self-harm: a propensity score-matched cohort study of SSRI and SNRI users in the USA. CNS Drugs, 28(1), 79-88. DOI: 10.1007/s40263-013-0120-8.

Robichaud, M., Koerner, N., & Dugas, M. J. (2019). Cognitive behavioral treatment for generalized anxiety disorder: From science to practice. Routledge.