Feb 23, 2024 NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
A Sample Answer For the Assignment: NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
Major Depressive Disorder is a mental health condition that affects millions of people worldwide. Depression can range from mild to severe, and its symptoms can be both acute and chronic. It can affect people of all ages, genders, and backgrounds and can have a significant impact on individuals, families, and society as a whole.
Depression is one of the leading causes of disability worldwide and can increase the risk of other health problems, such as heart disease, diabetes, and substance abuse. Fortunately, depression is a treatable condition, and various therapies, including medication, psychotherapy, and lifestyle changes, can help manage its symptoms.
Depressive Disorder Causes and Symptoms
Depressive disorder, also known as major depressive disorder, is a common mental health condition that is characterized by feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyable.
There is no single cause of depressive disorder, but it is believed to be a combination of biological, genetic, environmental, and psychological factors (Kakhramonovich, 2022). Some of the biological factors that can contribute to depressive disorder include an imbalance of chemicals in the brain, such as serotonin, norepinephrine, and dopamine.
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The symptoms of depressive disorder can vary from person to person, but typically include feelings of sadness, hopelessness, and a lack of interest in activities that were once enjoyable. Other common symptoms include fatigue, changes in appetite or sleep patterns, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of suicide or self-harm (Kakhramonovich, 2022). These symptoms can have a significant impact on an individual’s daily life, affecting their ability to work, socialize, and maintain relationships.
Depression in Adolescents
Adolescents are considered a vulnerable population when it comes to the diagnosis of depression because they are in a stage of development where they are undergoing significant changes, physically, emotionally, and mentally. Depression can be difficult to diagnose in adolescents because they may not be able to express their feelings in a way that is easily understood by others.
NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
Additionally, adolescents may not recognize that what they are feeling is depression or may feel embarrassed or ashamed to seek help (Daly, 2022). To diagnose depression in adolescents, mental health professionals typically conduct a thorough assessment that includes a review of the adolescent’s medical history, a physical exam, and a psychological evaluation. During the psychological evaluation, the clinician may use various assessment tools, such as self-report questionnaires, interviews, and observation, to evaluate the adolescent’s symptoms and assess the severity of their depression.
The criteria for diagnosing depression in adolescents are similar to those for adults and include a persistent feeling of sadness or emptiness, loss of interest or pleasure in activities, changes in appetite or weight, difficulty sleeping or oversleeping, fatigue, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of death or suicide (Daly, 2022). To be diagnosed with depression, these symptoms must be present for at least two weeks and must significantly impair the adolescent’s ability to function in daily life.
Medication Treatment Options
When it comes to treating depression in adolescents, medication is an option that can be considered after a thorough assessment by a mental health professional. Medications used to treat depression are known as antidepressants and work by changing the levels of certain chemicals in the brain that are responsible for mood regulation.
Antidepressants that have been approved by the FDA for use in adolescents include selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro), as well as serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor XR) (Park & Zarate, 2019). These medications have been found to be effective in reducing depressive symptoms in adolescents, although they do come with some risks and potential side effects.
One potential risk associated with the use of antidepressants in adolescents is the increased risk of suicidal thoughts and behaviors, particularly during the early stages of treatment. Therefore, it is crucial that adolescents taking antidepressants are closely monitored by their mental health professional and caregivers. Other potential side effects of antidepressants can include weight gain, sleep disturbances, sexual dysfunction, and gastrointestinal problems.
Therapy, lifestyle changes, and support from family and friends should also be a part of the treatment plan. The decision to use medication should be made on a case-by-case basis, weighing the potential benefits against the risks and side effects (Park & Zarate, 2019). Additionally, it is important to involve the adolescent and their family in the decision-making process and to ensure that they have a good understanding of the risks and benefits of medication treatment.
Medication Considerations
When prescribing medication for depression in adolescents, there are several aspects that should be taken into account. These include the severity of the symptoms, the potential benefits and risks of the medication, the patient’s medical history and current medications, and the patient’s personal preferences and beliefs (Park & Zarate, 2019).
Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro) are commonly prescribed antidepressants for adolescents. These medications work by increasing the levels of serotonin in the brain, which can help to regulate mood.
When writing a prescription for an antidepressant medication, it is important to include the following information:
The name of the medication: For example, “Fluoxetine 20 mg tablets.”
The dosage and instructions for use: For example, “Take one tablet by mouth every morning with food.”
The duration of the prescription: For example, “Dispense 30 tablets with one refill, to be taken daily for four weeks.”
Here are three examples of how to write a proper prescription for an antidepressant medication:
Fluoxetine 20 mg tablets: Take one tablet by mouth every morning with food, dispense 30 tablets with one refill, to be taken daily for four weeks
Sertraline 50 mg tablets: Take one tablet by mouth every day, preferably in the morning, dispense 30 tablets with two refills, to be taken daily for six weeks
Escitalopram 10 mg tablets: Take one tablet by mouth every day, with or without food, dispense 30 tablets with one refill, to be taken daily for eight weeks
Importance of Lab Tests
When prescribing medication for depression in adolescents, it is important to monitor their labs and any comorbid medical issues they may have. This is important for several reasons. One reason is that some antidepressant medications can cause liver damage. Therefore, it is important to monitor liver function with regular blood tests. This is especially important for adolescents who are taking other medications that can also affect the liver.
If liver function is impaired, the dosage of the antidepressant may need to be adjusted or the medication may need to be switched to a different one (Oh et al., 2019). Another important lab to monitor is the complete blood count (CBC). Some antidepressant medications can cause changes in blood cell counts, such as a decrease in white blood cells or platelets. This can increase the risk of infection or bleeding, respectively. Regular CBC monitoring can help catch these changes early and allow for appropriate management.
Special Considerations
Legal considerations refer to the laws and regulations that govern the prescribing of medication for minors. In many cases, parents or legal guardians must provide informed consent before a medication can be prescribed for a minor. It is important to ensure that this consent is fully informed and that the parents or guardians understand the potential risks and benefits of the medication. Additionally, it is important to be aware of any state or federal laws that govern the prescribing of certain medications to minors (Evans & Erickson, 2019).
It is important to consider issues such as autonomy, beneficence, non-maleficence, and justice. Healthcare professionals must ensure that they are acting in the best interests of the adolescent while respecting their autonomy and rights as a patient. Additionally, healthcare professionals must ensure that they are not causing harm to the adolescent and that the medication is being prescribed in a just and equitable manner.
Before prescribing medication in healthcare, it is important to consider their cultural background and beliefs. For example, some cultures may view mental illness differently than others, and may have different beliefs about the effectiveness of medication. Healthcare professionals should work to understand and respect these cultural beliefs, and tailor their treatment approach accordingly.
Adolescents from marginalized communities may face additional barriers to accessing mental health care, including lack of insurance, transportation, and language barriers (Evans & Erickson, 2019). It is important to consider these social determinants of health when prescribing medication for adolescents with depression, and to work to address these barriers in order to ensure that all adolescents have access to appropriate care.
Follow-up
One potential resource is my local community health center. These facilities often provide mental health services for adolescents and may have healthcare professionals on staff who can provide more information about the legal, ethical, cultural, and social considerations involved in prescribing medication for this population (Park & Zarate, 2019).
One may also want to reach out to local mental health advocacy organizations, such as the National Alliance on Mental Illness (NAMI) or Mental Health America. These organizations can provide information and resources related to mental health, including medication options for adolescents with depression.
Conclusion
Prescribing medication for patients with depression necessitates considerations of the legal, ethical, cultural, and social factors that can impact treatment outcomes. By taking these special considerations into account, healthcare professionals can ensure that they are providing the best possible care for their patients.
It is also important to remember that there are resources available in the local community, such as community health centers, mental health advocacy organizations, schools, and healthcare providers, that can provide further information and support related to medication treatment for adolescents with depression. By working together and building a network of support, we can improve outcomes for adolescents with depression and promote mental health and wellbeing for all.
References
Evans, C. R., & Erickson, N. (2019). Intersectionality and depression in adolescence and early adulthood: A MAIHDA analysis of the national longitudinal study of adolescent to adult health, 1995–2008. Social Science & Medicine, 220, 1-11. https://doi.org/10.1016/j.socscimed.2018.10.019
Daly, M. (2022). Prevalence of depression among adolescents in the U.S. from 2009 to 2019: Analysis of trends by sex, race/Ethnicity, and income. Journal of Adolescent Health, 70(3), 496-499. https://doi.org/10.1016/j.jadohealth.2021.08.026
Kakhramonovich, T. P. (2022). Epidemiology of Pysichiatric Disorders. Texas Journal of Medical Science, 12, 102-105. https://doi.org/10.15863/tas.2021.10.102.61
Oh, J., Yun, K., Maoz, U., Kim, T., & Chae, J. (2019). Identifying depression in the national health and nutrition examination survey data using a deep learning algorithm. Journal of Affective Disorders, 257, 623-631. https://doi.org/10.1016/j.jad.2019.06.034
Park, L. T., & Zarate, C. A. (2019). Depression in the primary care setting. New England Journal of Medicine, 380(6), 559-568. https://doi.org/10.1056/nejmcp1712493
Pharmacotherapy for Neurological Disorders
Neurological disorders, such as headaches, seizure disorders, sleep disorders, depression, and dementia can present several complications for patients of all ages. These disorders affect patients physically and emotionally, impacting judgment, school and/or job performance, and relationships with family and friends.
Since these disorders may have drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to manage the diagnosis, treatment, and education of patients with neurological disorders.
To prepare
Review this week’s media presentation on pharmacology for the nervous system.
Select one of the following neurological disorders: headaches, seizure disorders, sleep disorders, depression, or dementia. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.
Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects. NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
With these thoughts in mind:
By Day 3
Post a description of the neurological disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.
By Day 6
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different neurological disorder than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
Sample Week 5 Solution Incomplete
Depression is a common term in today’s healthcare environment. It manifests in many different forms. Major Depressive Disorder is one category of depression that affects 151 million individuals nationwide (Arcangelo, & Peterson, 2013).
It is a mood disorder that is a group of symptoms that interfere with an individual’s ability to function psychologically, emotionally or cognitively at baseline levels. Onset of MDD may occur at any point throughout an individual’s lifetime. NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
There are multiple theories to the cause of MDD. It is recognized and diagnosed by The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). They have established a list of criteria of which an individual must exhibit 5 of the characteristics for diagnosis (Arcangelo, & Peterson, 2013). Treatment is initiated based on severity of symptoms. There are many new pharmacological agents that are used to treat MDD.According to Arcangelo, & Peterson, 2013) …
NURS 6521 Walden Week 6 Discussion Latest
Pharmacotherapy for Endocrine and Musculoskeletal Disorders
Patients with endocrine and musculoskeletal disorders often require long-term treatment and care resulting in the need for extensive patient education. By appropriately educating patients, advanced practice nurses can assist patients with the management of their disorders. In clinical settings, patients with endocrine and musculoskeletal disorders typically seek treatment for symptoms that pose problems to their everyday lives as ordinary tasks may become difficult to complete.
For instance, patients might have difficulty walking short distances, preparing meals, or even running errands. To reduce these symptoms and additional health risks, it is essential to develop drug therapy plans with individual patient factors in mind.
To prepare:
Select one of the following endocrine or musculoskeletal disorders: thyroid disease, osteoarthritis, rheumatic arthritis, gout, multiple sclerosis, or fibromyalgia.
Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder. NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.
With these thoughts in mind:
By Day 3
Post a description of the endocrine or musculoskeletal disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.
By Day 6
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different endocrine or musculoskeletal disorder than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. NURS 6521N Advanced Pharmacology Wk5 Discussion Major Depressive Disorder
Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.
Many medications must reach their target cells and bind to a receptor in order to have an type of effect. Receptors are specialized proteins found inside the cell or on its membrane. Receptors can alter their shape or activity by binding it to a ligand which results in the cells changing activity or behavior. A medication that copies the action of the signal ligand by binding and activating a receptor is called an agonist.
An antagonist is a medication that typically binds to a receptor without activating them, but instead, decreases the receptor’s ability to be activated by another agonist and does nothing itself (Neff et al., 2019). An antagonist needs an agonist in order to have function and have any activity, even though it prevents the action of an agonist (Stahl, 2021). Partial agonists are drugs that stimulate receptors to a reduced degree than the natural neurotransmitter and limit efficacy in activating the receptor.
These are useful in medications when full activation is not needed like in opioid addiction. The partial agonist can bind to the opioid receptor helping ease the withdrawal symptoms without the patients getting the full effect and getting high. Inverse agonists have opposite actions of agonists because they both block agonists and reduce activity below the baseline level when no agonist is present (Stahl, 2021).
This is also important because it affects the efficacy of medications. Due to the inverse agonists blocking agonists, patients will not get the full effect of medications and could possibly take more or prescribed a higher dose of the medication and experience severe side effects.
Compare and contrast the actions of g couple proteins and ion gated channels.
G protein-couple receptors (GPCRs) are integral membrane proteins, are the largest family of receptors encoded by 800 genes, and help regulate many cellular and physiological processes, responding to a diverse range of extracellular stimuli including hormones, neurotransmitters, odorants, and light. The main function of membrane receptors is to relay extracellular signals to the cell interior, allowing cells to communicate with each other and sense the extracellular environment.
Without the interaction of G proteins, GPCR could not transmit signal to membrane-bound effectors including ion channels and enzymes. G proteins are heterotrimeric guanine nucleotide binding proteins composed of one Gα, one Gβ, and one Gγ subunit. Guanosine triphosphate (GTP) carries its energy and its inactive form of guanosine diphosphate (GDP). Upon agonist binding, GPCR promotes the exchange of GDP bound to the G proteins for GTP.
Receptors undergo conformational rearrangements that ultimately increase their affinity for G proteins, leading to G protein recruitment which interacts with the downstream proteins starting an output of intracellular signaling events (Calebiro et al., 2021). GPCR have a slower response because they involve multiple steps in signal transduction.
Ion Gated Channels
Ligated-gated ion channels (LGICs) are integral membrane proteins that contain a pore which allows the regulated flow of selected ions across the plasma membrane. These channels are open or gated in many ways by the binding of a neurotransmitter to an orthosteric site that triggers conformation change that results in the conducting state.
LGICs mediate fast synaptic transmission, on a millisecond time scale, in the nervous system and at the somatic neuromuscular junction when modulation of gating occurs by the binding of endogenous, or exogenous, modulators. This transmission involves the release of a neurotransmission from a pre-synaptic neuro that activates post-synaptical receptors that cause a rapid, phasic, electrical signal. Both g couple proteins and ion gated channels play important roles in cellular communication (IUPHAR, 2023).
Explain how the role of epigenetics may contribute to pharmacologic action.
Epigenetics is described as changes in gene expression by your behaviors and environment that affect the way your genes work without alteration in the DNA sequence. However, they can change the way your body reads a DNA sequence, and the way your body turns genes on and off. Pharmacologic action refers to drug interaction throughout the body and how the body reaches a therapeutic effect from the drugs, and epigenetics can play a role in the process.
Epigenetics is described as changes in gene expression by your behaviors and environment that affect the way your genes work without alteration in the DNA sequence. However, they can change the way your body reads a DNA sequence, and the way your body turns genes on and off. Epigenetics changes affect gene expression in different ways including DNA methylation and histone modification.
DNA methylation adds a chemical group to DNA where it blocks proteins that attach to DNA to “read” the gene which makes the cells more or less responsive to specific drugs. Histone modification is when DNA wraps around proteins either too tight or too loose. When histones are too tight packed the gene can’t be accessed and the gene is turned off when it should be turned on and when the histone are loose, more DNA is exposed, can be accessed by proteins and the gene is turned on when it should be off which can affect gene activity which change the drug metabolism, sensitivity, and resistance (Toth, 2021).
Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.
I work in the busiest ER in the United Stats and spend a lot of time in triage and see a lot of psych patients. On top of their psych problems, the patient are at times elderly, smoking and doing other drugs. DNA methylation can be affected by many things like smoking. People who smoke affect the AHRR gene.
Smokers tend to have less DNA methylation than people who do not smoke, and even less for heavy smokers (CDC, 2022). Practitioners need to be aware of this and make the necessary changes because irregular DNA methylation changes genes, can prevent the genes from doing what it is intended, and change how your body functions.
References
Calebiro, D., Koszegi, Z., Lanoiselée, Y., Miljus, T., & O’Brien, S. (2021). G protein-coupled receptor-G protein interactions: a single-molecule perspective. https://journals.physiology.org/doi/full/10.1152/physrev.00021.2020
Ligand-gated ion channels. (2023) IUPHAR/BPS Guide to PHARMACOLOGY. https://www.guidetopharmacology.org/GRAC/FamilyDisplayForward?familyId=697
Neff, K., Mueller, A., & Ingram, T. (2019). Pharmacodynamics: Agonist, partial agonist and antagonist. https://www.osmosis.org/learn/Pharmacodynamics:_Agonist,_partial_agonist_and_antagonist
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press
Toth, M. (2021). Epigenetic Neuropharmacology: Drugs Affecting the Epigenome in the Brain.
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