Reply Posts
Respond to a minimum of one peer on a separate day from your initial post. Your responses should be well-developed to each peer and answer all of the questions listed here. Integrate an evidence-based resource that is different than the one you used for the initial post.
List three specific medication-related treatment goals for the patient.
What drug therapy would you prescribe? Write the prescription. Provide rationale.
Describe specific patient monitoring based on the prescribed therapy; include labs and/or follow-up visits.
Discuss specific patient education based on the prescribed therapy. Give five to ten individual items you are going to explain to the patient about the medication, goal of therapy, common side effects, lifestyle modifications, etc.
List a minimum of two major adverse reactions for the selected agent that would cause you to change therapy.
Describe three major drug–drug or drug–food interactions for the selected agent.
Use APA format and integrate three evidence-based resources to include clinical practice guidelines as well as the course textbook.
Here is the post to be replied to: Jane Smith, a 28-year-old high school teacher, has been grappling with worsening symptoms of depression over the past six months. She lives with two roommates, with whom she gets along with mentioned that her attitude has changed recently. She has never had any major past medical history. Her daily life has been significantly impacted by persistent low mood, loss of interest in previously enjoyable activities, and chronic fatigue (Rosenthal & Burchum, 2021). Jane finds herself sleeping almost all weekend and when not working and continues to feel exhausted and unmotivated. Jane has also experienced a 10-pound weight gain due to changes in her appetite, often leading to comfort eating. The pizza delivery boy now knows her name.
At work, she struggles to concentrate and finds herself falling behind on grading and lesson planning, which further adds to her sense of inadequacy and hopelessness. Her co-workers have noticed that the energy she brings to her classroom has faded. Socially, Jane has withdrawn from friends and family, preferring to isolate herself at home.
During her evaluation, Jane was honest about her increasing difficulty in coping and her concern with her declining mental health. The only medication she takes is birth control pills, which she has taken for the past ten years. She expressed a willingness to try medication to help manage her symptoms and self-help strategies. After a thorough assessment and discussion of treatment options, Jane was diagnosed with Major Depressive Disorder (Rosenthal & Burchum, 2021).
References:
Rosenthal, L. D., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.
and here is an example of another student replying to a similar post where that patient had depression and anxiety disorder as well.
Example:
Hello
Thank you for sharing your post. In the case of Tom it appears he is suffering from social anxiety disorder (SAD) which falls under the umbrella term of anxiety disorder for which the first line treatment would be an approved SSRI (Rosenthal, & Burchum, 2021). A medication- related treatment goal for Tom would be to reduce anxiety symptoms with the aim to decrease intensity and frequency he experiences these anxious episodes (Leigh & Clark, 2018). Another goal would be for the medication to maintain long-term effectiveness and prevent recurrence of symptoms (Leigh & Clark, 2018). With effective medication managing of Tom’s social anxiety symptoms the goal of the medication would be to increase his functionality, allowing him to focus in class and improve his ability to engage in social interactions (Leigh & Clark, 2018).
List three specific medication-related treatment goals for the patient.
The first line medication treatment for SAD would include selective serotonin reuptake inhibitors (SSRIs) (Andrews et al., 2018). This medication class has been found to be very effective, safe and well tolerated for long term use when treating SAD (Andrews et al., 2018). SSRI are also commonly used to treat symptoms of depression which is a common comorbidity of anxiety disorders (Rosenthal, & Burchum, 2021). There are two SSRIs that are approved for treatment of SAD which include Paxil and Zoloft (Rosenthal, & Burchum, 2021).
Name Tom Brady 123 Tampa Bay circle
Paxil 20mg – Take tablet by mouth daily to manage anxiety.
Dispense 30 tablets Refills 0
NPI 12345678 DEA 0987654
After prescribing an SSRI it is important for a follow up visit within two to four weeks in order to assess tolerance and detect early side effects, subsequent follow ups should be every four to six weeks and in long term cases every three to six months (Eap et al., 2021). When a patient is taking SSRIs it is important to monitor CBC to check any blood abnormalities and liver function test because SSRI can impact liver enzymes (Eap et al., 2021).
Before prescribing the medication the provider should educate the patient on the purpose of the medication, Paxil is prescribed to treat depression and anxiety disorders; the goal of this medication therapy is to improve your mood, sleep, and energy levels, and help you regain functionality in social interactions (Medlineplus, 2022). The patient should be educated on how to take the medication, Paxil should be taken at the same time daily, usually in the morning (Medlineplus, 2022). The patient should be made aware of the expected benefits of Paxil and it may take several weeks to feel the full benefits of the medication (Medlineplus, 2022). The patient should be educated to not abruptly discontinue the medication, even if he is feeling better and should consult with his doctor before stopping (Medlineplus, 2022).The patient should be made aware of the common side effects of Paxil including nausea, dizziness, drowsiness, dry mouth, loss of appetite, or sexual dysfunction (Medlineplus, 2022). The patient should be informed of the increased risk of suicidal ideations with the use of this medication, especially with individuals under the age of 24 and he should immediately inform his provider if this does occur (Medlineplus, 2022). SSRI therapy would be stopped if the patient experiences an increase in suicidal ideations and reports sexual dysfunction including decreased libido, anorgasmia, and erectile dysfunction (Eap et al., 2021)
Paxil should not be combined with Adderall because SSRIs have been found to potentiate the effects of sympathomimetic agents (Paxil Interactions checker, 2024). Tramadol should not be combined with Paxil or other SSRIs because of the serotonergic activity of both medications the risk of serotonin syndrome is increased (Paxil Interactions checker, 2024). The patient should also be cautioned of the use of ibuprofen while taking Paxil because of the increased risk of bleeding, especially in older patients and those who have liver or kidney impairments (Paxil Interactions checker, 2024).
References
Andrews, G., Bell, C., Boyce, P., Gale, C., Lampe, L., Marwat, O., Rapee, R., & Wilkins, G. (2018). Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Australian & New Zealand Journal of Psychiatry, 52(12), 1109–1172. https://doi.org/10.1177/0004867418799453
Eap, C. B., Gründer, G., Baumann, P., Ansermot, N., Conca, A., Corruble, E., Crettol, S., Dahl, M. L., de Leon, J., Greiner, C., Howes, O., Kim, E., Lanzenberger, R., Meyer, J. H., Moessner, R., Mulder, H., Müller, D. J., Reis, M., Riederer, P., … Hiemke, C. (2021). Tools for optimising pharmacotherapy in Psychiatry (Therapeutic Drug Monitoring, molecular brain imaging and pharmacogenetic tests): Focus on antidepressants. The World Journal of Biological Psychiatry, 22(8), 561–628. https://doi.org/10.1080/15622975.2021.1878427
Leigh, E., & Clark, D. M. (2018). Understanding social anxiety disorder in adolescents and improving treatment outcomes: Applying the cognitive model of Clark and Wells (1995). Clinical Child and Family Psychology Review, 21(3), 388–414. https://doi.org/10.1007/s10567-018-0258-5
Paxil Interactions checker. Drugs.com. (2024, June 4). https://www.drugs.com/drug-interactions/paroxetine,paxil.html
Rosenthal, L. D., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier
U.S. National Library of Medicine. (2022, January 15). Paroxetine: Medlineplus drug information. MedlinePlus. https://medlineplus.gov/druginfo/meds/a698032.html
If you have questions please contact me Please please read the directions carefully and use scholarly references
thanks
