Short Answer Assessment Paper

Short Answer Assessment Paper

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?

The most appropriate drug therapy for major depressive disorder with alcoholism is the combination of an opioid antagonist (naltrexone) and selective serotonin reuptake inhibitors (sertraline). This combination has improved the mood disorder, causes a higher rate of abstinence from alcohol, and longer time to drinking relapse (Hunt, et al, 2020). Contraindicated drugs are bupropion and duloxetine. Bupropion has unacceptable adverse effects while duloxetine may cause chronic liver disease. The time frame for the resolution of symptoms is at 4 weeks. Short Answer Assessment Paper

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List 4 Predictors Of Late-Onset Generalized Anxiety Disorder.

Generalized anxiety disorder is a highly prevalent and chronic illness among the elderly. It is associated with disability and mortality. Risk factors for late-onset generalized anxiety disorder are the history of depression or anxiety, history of posttraumatic stress disorder, narcissistic personality disorder, longstanding vulnerability, and occurrence of a chronic illness (Siddarth, et al, 2020).

List 4 Potential Neurobiology Causes Of Psychotic Major Depression.

Neurobiological causes of psychotic major depression are both structural and functional. They are reduced brain-derived neurotrophic factors, abnormal function of the hypothalamic-pituitary-adrenal axis, glutamate-mediated toxicity, and increased activity of the limbic structures (van Dam . et al, 2020).

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.  Short Answer Assessment Paper 

According to the DSM-5 criteria for the diagnosis of major depressive disorder have at least five of the following symptoms. They are depressed mood (extreme sadness), loss of interest and pleasure, sleep disturbances (insomnia or hypersomnia), reduced ability to think or concentrate, and recurrent suicidal ideation (Ionescu,  et al, 2020)

List 3 Classes Of Drugs, With A Corresponding Example For Each Class, That Precipitate Insomnia.

According to Burman, D. (2017), some drugs can cause a patient to experience sleeping especially insomnia. These drugs are classified; selective serotonin reuptake inhibitors SSRI-antidepressants such as fluoxetine. Beta-blockers cause insomnia by inhibiting night melatonin that regulates sleep. An example of a beta-blocker is atenolol. Corticosteroids are used to manage inflammation for example triamcinolone exhaust the adrenal glands hence preventing relaxation and sleep.

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 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. Short Answer Assessment Paper

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. Learning Resources Required/Optional Readings (click to expand/reduce) American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Fernandez-Mendoza, J., & Vgontzas, A. N. (2013). Insomnia and its impact on physical and mental health. Current Psychiatry Reports, 15(12), 418. https://doi.org/10.1007/s11920-012-0418-8 Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/ Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R. (2007). Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. SLEEP, 30(12), 1705–1711. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_Narcolepsy.pdf Morgenthaler, T. I., Owens, J., Alessi, C., Boehlecke, B, Brown, T. M., Coleman, J., Friedman, L., Kapur, V. K., Lee-Chiong, T., Pancer, J., & Swick, T. J. (2006). Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. SLEEP, 29(1), 1277–1281. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_NightWakingsChildren.pdf Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307–349. https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470 Winkleman, J. W. (2015). Insomnia disorder. The New England Journal of Medicine, 373(15), 1437–1444. https://doi.org/10.1056/NEJMcp1412740 Short Answer Assessment Paper

References

Burman, D. (2017). Sleep Disorders: Insomnia. FP essentials, 460, 22-28.

304. E., Malhi, G. S., Lai, H. M. X., & Cleary, M. (2020). Prevalence of comorbid substance use in major depressive disorder in the community and clinical settings, 1990–2019: Systematic review and meta-analysis. Journal of Affective Disorders, 266, 288-304.

Ionescu, D. F., Li, X., Lane, R., Lim, P., Sanacora, G., … & Canuso, C. M. (2020). Esketamine nasal spray for rapid reduction of major depressive disorder symptoms in patients who have active suicidal ideation with intent: a double-blind, randomized study (ASPIRE I). The Journal of clinical psychiatry, 81(3), 0-0.

Siddarth, P., Funes, C. M., Laird, K. T., Ercoli, L., & Lavretsky, H. (2020). Predictors of Cognitive Improvement Following Treatment for Late-Life Depression. Journal of Geriatric Psychiatry and Neurology, 0891988720915515.

van Dam, A. M., Wang, Y., Lucassen, P. J., & Zhou, J. N. (2020). Retinoic acid and depressive disorders: Evidence and possible neurobiological mechanisms. Neuroscience & Biobehavioral Reviews. Short Answer Assessment Paper