Assignment 1: Short Answer Assessment
Student's Name
Institutional Affiliation
Course
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Assignment 1: Short Answer Assessment
Student's Name
Institutional Affiliation
Course
Instructor
Due Date
This study source was downloaded by 100000831988016 from CourseHero.com on 04-06-2022 01:29:39 GMT -05:00
https://www.coursehero.com/file/84835106/NURS-6630-Week-8-Assignment-1docx/
2
Assignment 1: Short Answer Assessment
Question 1: 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 a resolution of symptoms?
The optimal treatment of patients with Major Depressive Disorder requires an awareness
of their comorbid alcohol abuse history and vise versa. The optimal course of treatment for
patients diagnosed with MDD and alcohol dependence is a combination of sertraline (Zoloft) 50
mg orally day taken in the morning and naltrexone 50 mg orally daily for 12 weeks. Zoloft is a
selective serotonin reuptake inhibitor (SSRI) antidepressant that increases serotonin levels in
the brain, which is responsible for enhancing moods (IBM Corporation, 2020). On the other
hand, naltrexone works by blocking the euphoric, soothing effects of drugs.
The contraindicated drugs for the therapy with comorbid alcohol abuse treatment in
MDD are Methadone and Buprenorphine, which work by activating the opioid receptors in the
body, thereby reducing the cravings for drugs. Methadone reacts with Zoloft to increase the risk
of an irregular heart rhythm. Besides, combining sertraline with Buprenorphine can cause a rare
condition referred to as serotonin syndrome, which causes hallucinations, confusion, seizures,
increased heart rate, extreme changes in blood pressure, excessive sweating, fever, blurred
vision, and shivering and shaking (APA, 2013). Contraindications for Zoloft include patients
taking or stopped taking MAOIs within 14 days, pimozide, or with known hypersensitivity to
sertraline. The patient should see the resolutions from the fourth week of initiation of the
therapy.
Question 2: List 4 predictors of late-onset generalized anxiety disorder
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The principal predictors of the late-late onset of generalized anxiety disorder over 12
years, according to the multivariate Cox model, include the following:
Recent adverse life events
Being female
Having chronic physical health disorders such as heart failure, cognitive impairment, or
dyslipidemia
Having mental health disorders such as depression, previous history of generalized
anxiety disorder, or phobia.
Question 3: List 4 potential neurobiology causes of psychotic major depression
The neurotransmitters linked to the causes of psychotic major depression include
dopamine, serotonin, and norepinephrine. The following are some of the neurobiological
causes of psychotic major depression
Lower levels of neurotransmitters since most antidepressants work by increasing their
levels
A reduced serotonin synthesis in depressed individuals
Low levels or depletion of tryptophan, and
Polymorphisms
Question 4: List at least five symptoms required for the episode to occur. Be specific.
The following are some of the symptoms that must persist for at least two weeks for a
diagnosis to be considered as a major depressive disorder:
Worrying more than average about their physical health
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Extended episodes of anxiety
Excessive conflict in relationships
Sexual functioning problems, and
Increased alcohol intake and other substances (Sateia et al., 2017)
Question 5: List 3 classes of drugs, with a corresponding example for each class, that
precipitate insomnia. Be specific.
Selective serotonin reuptake inhibitors (SSRIs). Examples include Zoloft and Prozac
Beta-agonists are used to relax the muscles of the airways, thereby widening the airways
to improve breathing. Examples include Brovana, Perforomist, Maxair, and
Metaproterenol
Anticonvulsants medications used to treat epileptic seizures such as Mazepine,
Acetazolam, Frisium, and Diazepam (Fernandez-Mendoza & Vgontzas, 2013)
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References:
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
IBM Corporation. (2020). IBM Micromedex.
https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?
source=deepLink&institution=SZMC%5ESZMC%5ET43537
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 Med
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