b’nRead a selection of your colleaguesxe2x80x99 responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patientxe2x80x99s pathophysiology.xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0Main PostDepression Scenarioxc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0The interactive depression scenario described a 70-year-old male who presented with complaints of depression (Laureate Education, 2019). He also reported shoulder pain related to warehouse labor, experiencing the death of his mother at a young age, being an outsider at school, anhedonia, recent weight gain, insomnia, and poor concentration (Laureate Education, 2019). On exam, he had poor eye contact, soft speech, constricted affect without evidence of psychosis or suicidal/homicidal ideation (Laureate Education, 2019). For the first decision, I chose to start the patient on Zoloft 25 mg oral daily. When the patient returned four weeks later with a 25 percent improvement of depressive symptoms and a new onset of erectile dysfunction, I chose to add Wellbutrin IR 150 mg in the morning. When the patient came in four weeks later with the continued decrease of depressive symptoms, no erectile dysfunction, and feelings of increased nervousness, I chose to change the Wellbutrin order to Wellbutrin XL 150 mg oral in the morning.xc2xa0Pharmacotherapeutic Impact on Pathophysiologyxc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0When choosing initial treatment options for depression, the classes of medications have similar efficacy, so it is best to focus on safety and medication tolerance (Rosenthal & Burchum, 2018). Therefore, I chose to start with a Selective Serotonin Reuptake Inhibitor (SSRI), recognized as the safest and most tolerated medications for treating major depression (Rosenthal & Burchum, 2018). The pathophysiology of these medications is unclear; however, the theory suggests that these medications compensate for serotonin deficiency in the synapse (Holck, Wolkowitz, Mellon, Reus, Nelson, Westrin, & Lindqvist, 2019). Serotonin is needed to regulate sleep, mood, and cognition (Holck et al., 2019). By increasing the amount of Serotonin in the synapse, this patientxe2x80x99s depressive symptoms decreased.xc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0In the second decision, I chose to add Wellbutrin IR to the patientxe2x80x99s medication regimen to help treat his erectile dysfunction symptoms. Wellbutrin is an atypical antidepressant where the mechanism of action is also not understood (Rosenthal & Burchum, 2018). However, the effects may be related to blocking the reuptake of dopamine, which regulates behavior and influences learning, and norepinephrine, which plays a role in getting the brain and body ready for action (Berke, 2018; Rosenthal & Burchum, 2018). While Wellbutrin helps depression, it also seems to help with sexual desire (Rosenthal & Burchum, 2018). Fortunately, this additional medication helped the patient in the scenario. After four weeks of taking both drugs, he had a continued decrease in depressive symptoms and no longer struggled with sexual dysfunction.xc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0In my third decision, I chose to change the Wellbutrin order to extended-release since the patient was experiencing restlessness symptoms. The immediate-release may have been too much, too fast for the patient as it reaches its peak two hours after administration (Rosenthal & Burchum, 2018). Extended-release Wellbutrin reaches its peak at five hours with a half-life of approximately 21 hours (Food and Drug Administration, n.d.). This change will help to settle the experienced side effects of the medication.xc2xa0Treatment Plan The effect of Zoloft and Wellbutrin on the patientxe2x80x99s pathophysiology will impact the patientxe2x80x99s treatment plan. Common side effects of SSRIs include weight gain, insomnia, sexual dysfunction, and increased risk of suicide (Rosenthal & Burchum, 2018). I already addressed sexual dysfunction by adding Wellbutrin, but the monitoring for the other side effects is also essential for safety and compliance purposes. The patient already has had a significant amount of weight gain and complains about insomnia. Therefore, follow up appointments are necessary for close monitoring of these possible side effects. Treatment should include education about proper diet and activity to regulate weight. The provider should also assess the patientxe2x80x99s sleep to ensure the medication is helping rather than worsening the amount and quality of sleep. It is also crucial for the provider to educate the patient on the increased risk of suicide and encourage the patient to seek help immediately if he starts having these thoughts. The provider should assess the patient for suicidal ideation frequently.xc2xa0xc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0 xc2xa0Wellbutrin is usually well tolerated; however, it carries a risk for seizures and psychotic symptoms. Therefore, the provider should assess for any seizure risk factors such as a history of seizures, a head injury, an eating disorder, or a CNS tumor (Rosenthal & Burchum, 2018). The provider should also assess the patient for psychotic symptoms at each follow-up visit, such as hallucinations or delusional thoughts (Rosenthal & Burchum, 2018).xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0ReferencesBerke, J.D. (2018). What does dopamine mean? Nature Neuroscience, 21(6), 787-793. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29760524Food and Drug Administration. (n.d.). Wellbutrin XL. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021515s026s027lbl.pdfHolck, A., Wolkowitz, O. M., Mellon, S. H., Reus, V. I., Nelson, J. C., Westrin, xc3x85., & Lindqvist, D. (2019). Plasma serotonin levels are associated with antidepressant response to SSRIs.xc2xa0Journal of Affective Disorders,xc2xa0250, 65xe2x80x9370. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jad.2019.02.063Laureate Education (Producer). (2019). Adult geriatric depression [Interactive media file]. Baltimore, MD: Author.Rosenthal, L. D., & Burchum, J. R. (2018). Lehnexe2x80x99s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier. ‘
https://customwrites.com/wp-content/uploads/2021/09/logo-300x75.png 0 0 admin https://customwrites.com/wp-content/uploads/2021/09/logo-300x75.png admin2021-09-30 15:32:472021-09-30 15:32:47b’Read a selection of your colleaguesxc2x92 responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and pr’
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