SELF ASSESSMENT: ASSESSING AND TREATING PATIENTS WITH PSYCHOPHARMACOLOGY NURS 6630

A Sample Answer For the Assignment: SELF ASSESSMENT: ASSESSING AND TREATING PATIENTS WITH PSYCHOPHARMACOLOGY NURS 6630

Psychopharmacology entails the research of mental disorder treatments. Experts in this field require comprehensive awareness for every possible clinically pertinent ideology of pharmacokinetics (how the body reacts to the set medication), together with pharmacodynamics (how the medicine reacts to the body).

An in-depth understanding is thus required for aspects such as the binding of proteins in terms of the availability of the medicine to the patient’s body; half-life, regarding the length of the medicine presence within the patient’s body; polymorphic genes, as per the genes that differ to a great extent from one individual to the next; and the inter-drug reactions, in terms of how the set medicines impact each other (ASCP, 2020). Application of the underlying medications requires far-reaching awareness of rudimentary neuroscience, rudimentary psychopharmacology, clinical medicine, varying mental disorder diagnoses, and the treatment possibilities that are needed.

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The agonist-to-antagonist spectrum of action of psychopharmacologic agents

Agonists’ actions dwell on the imitating of actions of set endogenous neurotransmitters. It is, however, important to note that the net action is not essentially aimed at inspiring synaptic transmission due to the impact that presynaptic auto-receptors may possess. The agonist spectrum is made up of four constituents that include the agonists, the partial agonist, antagonists, and the inverse agonist.

Antagonists, on the other hand, barricade the impact of endogenous neurotransmitters and conflict with regular synaptic transmission. It is, however, noteworthy to consider that some instances showcase actions of predominance on presynaptic receptors tending to heighten neuronal shooting, thereby amassing the release of neurotransmitters. Agonists act by exposing the set channel thereby increasing the extent as well as an occurrence that is permissible within the binding area. The antagonist present within the spectrum’s central place holds the resting condition through aspects of irregular exposure of the channel.

This causes the reverse antagonist to set the ion channel within a set locked coupled with an inactive condition. Since the antagonists have the capability of barricading matter within the agonist spectrum, a returning of ions is initiated to the resting condition for every occurrence (Zimmer, 2016). A set antagonist fixates within the receptor area and leads to an outcome, while the antagonist is reacting to the medicine and barricading the set receptor.

A set agonist inspires the activity as the antagonist remains in an inactive condition. An ultimate therapeutic activity of medication necessitates for ion movement coupled with the transduction of indicators with the right form of equilibrium in terms of hotness or coldness.     

Comparison of g-couple protein activity to ion gated channels

G-protein actions control the functioning of cells by regulating the set ion channels from intracellular sides. This is done through membranous receptors. An amalgamation of seven trans-membrane territory-holding proteins, the g-proteins across the cell membranes orchestrate as well as inspire several cellular outcomes through controlling the actions of various enzymes and ionic channels (Zhou, Melcher, & Xu, 2018).

Particular numbers of ionic channels are directly regulated by the g proteins. The g protein arbitrated varied modifications impact the ion channel actions and the spatiotemporally control membranous capability coupled with intracellular Ca²⁺ focusses within excitatory together with non-excitatory cells.   

Role of epigenetics in pharmacologic activity

Epigenetic variations are significant in the standard as well as illness state of organisms.  The variations may entail methylation, acetylation, phosphorylation, as well as ubiquitylation of the DNA together with the activity of the histamine proteins, the nucleosomes, and chromatic reframing. The alterations in genetic expression that exhibit independence of the set genetic DNA classification may lead to epigenetic inheritance as well as illnesses that relate to alterations of the organism. The epigenetic alterations or information may be enhanced transgenerationally to the daughter cells through various somatic cell divisions. A set organism’s genome can be altered through several chemical compounds together with species within the biological framework, which then causes alterations within the genetic expression (epigenome). An organism’s genotype upholds the competence of showcasing phenotypic alterations due to the impact of various environmental aspects, known as plasticity (Rasool et al., 2015). The best form of plasticity takes place in the process of progression for enhancing the endurance rates and generative accomplishment of organisms. This enables some pharmacologic action to control the epigenetic mechanism of humans to fight illnesses.  

Question 1

1. Martin is a 92-year-old male who presents to the clinic with signs/symptoms consistent with MDD. The patient suffers from glaucoma and just recently underwent surgery for a cataract. Which of the following is the LEAST appropriate course of therapy when treating the MDD?

	a.	sertraline
	b.	amitriptyline
	c.	duloxetine
	d.	vilazodone

0 points  

Question 2

1. Mark is a 46-year-old male with treatment-resistant depression. He has tried various medications, including SSRIs, SNRI, and TCAs. You have decided to initiate therapy with phenelzine. Which of the following must the PMHNP take into consideration when initiating therapy with phenelzine?

	a.	There is a minimum 7-day washout period when switching from another antidepressant to phenelzine.
	b.	Patient must be counseled on dietary restrictions.
	c.	MAOIs may be given as an adjunctive therapy with SSRIs.
	d.	A & B
	e.	All of the above

0 points  

Question 3

1. Earle is an 86-year-old patient who presents to the hospital with a Community Acquired Pneumonia. During stay, you notice that the patient often seems agitated. He suffers from cognitive decline and currently takes no mental health medications. Treatment for the CAP include ceftriaxone and azithromycin. The LEAST appropriate medication to treat Earle’s anxiety is:

	a.	sertraline
	b.	duloxetine
	c.	citalopram
	d.	venlafaxine

0 points  

Question 4

1. Richard is a 54-year-old male who suffers from schizophrenia. After exhausting various medication options, you have decided to start him on Clozapine. Which of the statements below is true regarding Clozapine?

	a.	Regular blood monitoring must be performed to monitor for neutropenia.
	b.	Clozapine can only be filled by a pharmacy that participates in the REMS program.
	c.	Bradycardia is a common side effect of Clozapine.
	d.	A & B
	e.	All of the above

0 points  

Question 5

1. Sam is a 48-year-old male who presents to the clinic with signs and symptoms consistent with GAD & MDD. Which of the following medications would be the LEAST appropriate choice when initiating pharmacotherapy?

	a.	duloxetine
	b.	sertraline
	c.	mirtazapine
	d.	buproprion

0 points  

Question 6

1. Which of the following medications, when given intramuscularly, is most likely to cause severe postural hypotension?

	a.	haloperidol
	b.	lorazepam
	c.	benztropine
	d.	chlorpromazine

0 points  

Question 7

1. Jane is a 17-year-old patient who presents to the office with signs consistent with schizophrenia. She states multiple times that she is concerned about gaining weight, as she has the perfect prom dress picked out and she finally got a date. Which of the following is the least appropriate choice to prescribe Jane?

	a.	Aripiprazole
	b.	Olanzapine
	c.	Haloperidol
	d.	Brexpiprazole

0 points  

Question 8

1. Jordyn is a 27-year-old patient who presents to the clinic with GAD. She is 30 weeks pregnant and has been well controlled on a regimen of sertraline 50mg daily. Jordyn says that “about once or twice a week my husband really gets on my nerves and I can’t take it.” She is opposed to having the sertraline dose increased due to the risk of further weight gain. You have decided to prescribe the patient a short-term course of benzodiazepines for breakthrough anxiety. Which of the following is the LEAST appropriate benzodiazepines to prescribe to this patient?

	a.	diazepam
	b.	alprazolam
	c.	clonazepam
	d.	lorazepam