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.
Assignment #1 – Short Answer Assessment
As you complete this assignment, please keep in mind that you are to concisely answer the following questions within the stated guidelines. Your answers should be short, to the point, and address only what the question is asking. Be sure to include references
- 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 depressive 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.
*** a file with the rubric for grading is attached
*** references should be within past 5 years
Expert Solution Preview
Introduction:
Psychopharmacologic treatments play a crucial role in improving the overall health and well-being of patients with mental health disorders. As a medical professor, I have designed this Assignment to provide medical college students with the opportunity to review and apply their understanding of psychopharmacologic treatments for patients with multiple mental health disorders. This short answer assessment covers the appropriate drug therapy for MDD and a history of alcohol abuse, predictors of late onset generalized anxiety disorder, potential neurobiology causes of psychotic major depression, symptoms required for an episode of major depression to occur, and classes of drugs that precipitate insomnia.
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 depressive symptoms?
The appropriate drug therapy for a patient with MDD and a history of alcohol abuse is a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine, sertraline, or escitalopram. Contraindicated drugs are monoamine oxidase inhibitors (MAOIs) because of the potential risk of hypertensive crisis. The resolution of depressive symptoms with SSRI therapy can take up to 4-6 weeks.
References:
American Psychiatric Association. (2010). Practice guideline for the treatment of patients with major depressive disorder.https://doi.org/10.1176/appi.books.9780890423387.
2. List 4 predictors of late onset generalized anxiety disorder.
Four predictors of late onset generalized anxiety disorder are female sex, negative life events, comorbid medical illness, and lower educational level.
References:
Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013). Current diagnosis and treatment of anxiety disorders. P & T : a peer-reviewed journal for formulary management, 38(1), 30–57.
3. List 4 potential neurobiology causes of psychotic major depression.
Four potential neurobiology causes of psychotic major depression are abnormalities in the hypothalamic-pituitary-adrenal axis, decreased prefrontal cortical activity, increased activity in the amygdala, and increased levels of proinflammatory cytokines.
References:
Jain, R., & Mahableshwarkar, A. R. (2015). A systematic review of the treatment of psychotic depression. Acta psychiatrica Scandinavica, 131(3), 185–196. https://doi.org/10.1111/acps.12378
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.
Five symptoms required for an episode of major depression to occur are depressed mood, loss of interest or pleasure in nearly all activities, significant weight loss or gain, insomnia or hypersomnia, and psychomotor agitation or retardation.
References:
American Psychiatric Association. (2010). Practice guideline for the treatment of patients with major depressive disorder. https://doi.org/10.1176/appi.books.9780890423387.
5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.
Three classes of drugs that precipitate insomnia are psychostimulants (e.g., methylphenidate), selective serotonin reuptake inhibitors (e.g., fluoxetine), and corticosteroids (e.g., prednisone).
References:
American Academy of Sleep Medicine. (2017). International classification of sleep disorders. American Academy of Sleep Medicine.
https://aasm.org/resources/pdf/icssramp.pdf.
