Category: Pharmacology

• Choose a pharmaceutical drug and answer the following questions about the drug:
◦ What is the IUPAC chemical name?
◦ Who discovered it or what company discovered it and when (if available)?
◦ What does the compound look like? Provide a picture of the compound.
◦ What are the functional groups in the compound?
◦ What are the medical uses for the drug?
◦ What is the mechanism of action of the drug (how does it work to affect the disease or malady)?
◦ How is it usually administered (ex. IV, pill, etc.)?
◦ What are the potential adverse effects of the drug?
◦ Ask ONE (1) clarifying question about The pharmaceutical topic you choose.

Case study:
Jeremy Stewart (pronouns he, him, his) is a 44-year-old married father of three who sees you for a psychiatric evaluation. Jeremy is a professor at a local college where he teaches art. He also has a small art studio close to campus where he paints. As his psychiatric nurse practitioner, you diagnose Jeremy with bipolar I disorder, most recent episode depressed.
When treating a person for bipolar disorder, you have several medications from which to choose. You decide to start Jeremy on Lamictal (lamotrigine).
What psychiatric disorders and/or symptoms is Lamictal indicated to treat? What phase of bipolar (manic, mixed, or depressed) is Lamictal most effective in managing? How does Lamictal work, and what is the mechanism of action? What is the dosing titration schedule for Lamictal? If Jeremy told you he had not taken Lamictal in over 1 week, how would you handle prescribing Lamictal to him?
Provides 2 or more references with in-text citations to current literature and assigned readings to support assertions made

Depending on the board of nursing in your state, there may be additional requirements to become a prescriber after you complete your APRN program. For example, those who are being licensed/practicing in California are required to take an additional 3-hour pharmacology course for prescribing privileges. Describe the necessary steps required, for your state, in order to become a prescriber. Hypothetically, after you have completed these steps, you decide to celebrate on a family vacation in a different state. Your sister asks you to refill her levothyroxine because she forgot to pack her medication. What are the legal and ethical implications in your state as a new prescriber?

Kristin is a 26-year-old client who presents to the outpatient clinic with complaints of “not liking myself.” She states she frequently feels angry without provocation and cries often. She has lost 10 lbs. in the past month and states she has no appetite. Kristin reports nightly sleep difficulty, both falling and staying asleep. Her mind just can’t seem to relax enough so she can sleep. She has tried melatonin and the Calm app mindfulness techniques; they help some nights but not always. She endorses having difficulty focusing for long periods, and she has missed several days of work within the past month due to her symptoms. No hallucinations or delusions are voiced. She states “The only thing that makes me feel better is shopping online. I love getting packages every day.” She is not experiencing financial issues from online shopping, but she has depleted her savings account. She reports that when she is not sad, she loves crafting and sometimes has days where she can craft “all day and all night.” The crafting can last for 3-4 days in a row. She denies thoughts of self-harm or suicide.
Past Psychiatric History 
self-reported “panic attacks” including shortness of breath and nausea; no formal psychiatric diagnosis, no treatment
Past Medical History 
no medical or surgical history 
no known allergies 
Social history 
no alcohol use 
vapes nicotine daily
no illicit drug use 
single, not in a relationship currently, prefers male partners.
lives with two roommates
educational level: bachelor’s degree 
employment: employed full time as a technical writer, works from home 
hobbies: crochet and papercrafts
Family history 
mother: alive, 55, no medical history, psychiatric history of depression  
father: alive, 57, history of type 2 DM, no psychiatric history 
siblings: only child 
Medications 
no prescription medications 
Mental Status Examination
Casual attire, well-groomed, no motor abnormalities. Cooperative, good eye contact. Alert and oriented x 3. Speech is clear, normal rate and volume. Mood is depressed, irritable, and angry. Affect is appropriate, congruent to mood. Does not appear to respond to external stimuli. Memory grossly intact, fair concentration and attention. Thought processes are coherent with average intellectual functioning. Thought processes appear organized and content is appropriate to subject. Denies suicidality or homicidality. Insight and judgment are fair.
Application of Knowledge: The student post demonstrates the application of knowledge.Select an appropriate screening tool for Kristin and provide a score for the tool.
Provide a rationale for the screening tool you selected.
Determine the most likely diagnosis for Kristin based on the available information.
Provide the ICD-10-CM code for the selected diagnosis
Provide a treatment plan with rationale for each plan step.
Differentiate the clinical presentations of psychosis and agitation in clients with dementia.
Discuss two possible approaches to treatment for agitation.
Identify at least two strategies to suggest to a caregiver for a client who is experiencing agitation in the home environment.
Identify at least two strategies to suggest to staff for a client who is experiencing aggressive behavior in the long-term care environment.

As part of your discussion, answer the following five (5) questions:
According to the author of each article, what has been and is the role of the mass media?
How is social media (YouTube, Twitter, Facebook, etc.) changing the landscape regarding “drug messages”?
What new forms of or enhancements to social media can you envision over the next 5 years? How will be media’s role and hence its impact change in the future?
How can the Pharmacists’ voices be heard in this new media environment?
Given the rapidly moving marijuana legalization landscape, what biases now seem to be present in Nixon’s “War on Drugs”?

discussing at least 5 routes of administration medications can be administered to a patient discuss the pros and cons each route and why or why not this route for a patient, include specific examples and drug names for medication included for each category. include citations for credit.

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER
Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.
Generalized Anxiety Disorder is a psychological condition that affects 6.1 million Americans, or 3.1% of the US Population. Despite several treatment options, only 43.2% of those suffering from GAD receive treatment. This week you will review several different classes of medication used in the treatment of Generalized Anxiety Disorder. You will examine potential impacts of pharmacotherapeutics used in the treatment of GAD. Please focus your assignment on FDA approved indications when referring to different medication classes used in the treatment of GAD.
RESOURCES
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources. WEEKLY RESOURCES
To Prepare:
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history with GAD.
BY DAY 3 OF WEEK 8
Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.
Resources Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 26, “Antipsychotic Agents and Their Use in Schizophrenia” (pp. 203–213)
Chapter 27, “Antidepressants” (pp. 214–226)
Chapter 28, “Drugs for Bipolar Disorder” (pp. 228–233)
Chapter 29, “Sedative-Hypnotic Drugs” (pp. 234–242)
Chapter 30, “Management of Anxiety Disorders” (pp. 243–247)
Chapter 31, “Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder” (pp. 248–254)
MUST BE IN APA
MUST HAVE AT LEAST 3 references References must be less than 5 years
ANSWER
**Introduction**
Generalized anxiety disorder (GAD) is the most common anxiety disorder in the United States, affecting approximately 6.8 million adults (3.2% of the population) ages 18 and older each year. GAD is characterized by excessive worry and anxiety that occurs most days of the week for at least 6 months. People with GAD may experience a variety of physical symptoms, such as restlessness, fatigue, muscle tension, irritability, and difficulty concentrating. GAD can have a significant impact on a person’s quality of life, making it difficult to work, go to school, and maintain relationships.
There are a number of different treatment options available for GAD, including psychotherapy, medication, and a combination of both. Medication can be an effective treatment for GAD, but it is important to choose the right medication and dose for each individual. Some of the most commonly used medications for GAD include:
* **Selective serotonin reuptake inhibitors (SSRIs)**: SSRIs work by increasing the levels of serotonin in the brain. Serotonin is a neurotransmitter that plays a role in mood regulation. SSRIs are generally well-tolerated and are considered to be the first-line treatment for GAD.
* **Serotonin-norepinephrine reuptake inhibitors (SNRIs)**: SNRIs work by increasing the levels of both serotonin and norepinephrine in the brain. Norepinephrine is another neurotransmitter that plays a role in mood regulation. SNRIs are also effective in treating GAD and may be a good option for people who do not respond to SSRIs.
* **Benzodiazepines**: Benzodiazepines are fast-acting medications that are effective at relieving anxiety symptoms. However, benzodiazepines can be habit-forming and should only be used for short-term treatment of GAD.
**Pharmacokinetics and Pharmacodynamics of Anxiolytic Medications**
Pharmacokinetics is the study of how drugs are absorbed, distributed, metabolized, and excreted by the body. Pharmacodynamics is the study of how drugs interact with their target receptors and produce their effects.
**Absorption**
SSRIs and SNRIs are well-absorbed from the gastrointestinal tract. Benzodiazepines are also well-absorbed, but they can be more rapidly absorbed when taken orally than when taken sublingually or rectally.
**Distribution**
SSRIs and SNRIs are widely distributed throughout the body, including the brain. Benzodiazepines are also widely distributed, but they have a higher affinity for the brain than SSRIs and SNRIs.
**Metabolism**
SSRIs and SNRIs are metabolized by the liver. Benzodiazepines are also metabolized by the liver, but they can also be metabolized by other tissues, such as the kidneys.
**Excretion**
SSRIs and SNRIs are excreted in the urine and feces. Benzodiazepines are also excreted in the urine and feces, but they can also be excreted in the breast milk.
**Target Receptors**
SSRIs and SNRIs work by increasing the levels of serotonin and/or norepinephrine in the brain. Serotonin and norepinephrine are neurotransmitters that are involved in mood regulation. Benzodiazepines work by binding to GABA receptors in the brain. GABA is a neurotransmitter that has inhibitory effects on the nervous system.
**Onset of Action**
SSRIs and SNRIs typically take several weeks to start working. Benzodiazepines, on the other hand, start working very quickly.
**Duration of Action**
SSRIs and SNRIs have a long duration of action, typically lasting for 12-24 hours. Benzodiazepines have a shorter duration of action, typically lasting for 4-6 hours.
**Side Effects**
SSRIs and SNRIs are generally well-tolerated, but they can cause side effects such as nausea, vomiting, diarrhea, headache, and dizziness. Benzodiazepines can also cause side effects such as drowsiness, dizziness, and impaired coordination.
**Comparison of Different Treatment Options**
**SSRIs and SNRIs**
SSRIs and SNRIs are the first-line treatment for GAD. They are generally well-tolerated and have a low risk of abuse and dependence. However, they can take several weeks to start working and can cause side effects such as nausea, vomiting, diarrhea, headache, and dizziness.
**Benzodiazepines**
Benzodiazepines are fast-acting medications that are effective at relieving anxiety symptoms. However, they can be habit-forming and should only be used for short-term treatment of GAD. Benzodiazepines can also cause side effects such as drowsiness, dizziness, and impaired coordination.
**Other Treatment Options**
Other treatment options for GAD include psychotherapy and a combination of medication and psychotherapy. Psychotherapy can help people to understand and manage their anxiety symptoms. A combination of medication and psychotherapy is often the most effective treatment for GAD.
**Conclusion**
There are a number of different treatment options available for GAD

Ms. Jones brings 6-week-old Sam to the clinic because of a bright red rash in the diaper area that has gotten worse since she started putting over-the-counter antibiotic cream on it 3 days ago. Sam is diagnosed with diaper Candida or a yeast infection. Clotrimazole (Lotrimin) topical TID for 14 days to the diaper area has been prescribed.
Briefly describe the therapeutic actions of Clotrimazole (Lotrimin).
Describe antifungal drugs uses and side effects.
Develop a teaching plan for Ms. Jones including age-appropriate considerations for Sam.
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Please answer with question and then answer. All the questions should equal up to no less than 500 words. Citing and resources required.

In this written assignment, select one cultural factor such as health beliefs, language, perception of time, environment control, etc. (see textbook reading) and apply it to a selected ethnic group. The paper will include the following:
One impact on medication preparation. Explain.
Two impacts on medication administration. Explain.
Two potential adverse reactions. Explain with rationale.
One possible issue in adherence to medication regimen. Explain how this can be overcome.
The paper should be no more than 3 pages. Use APA Editorial Format for all citations and references used.
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Write a 2- to 3-page paper that addresses the following:
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
Here is the patient case you will need to research for your week 2 assignment if you want to start working on it this weekend:
BN is a 74-year-old African American male who is seeing his PCP because he noticed when he woke up that his “heart was not beating right; it feels like it is going to slow.” He denies chest pain, SOB, N/V. He notes feeling dizzy earlier in the day. 6 weeks earlier his PCP started him on Diltiazem CD to further lower his BP to goal. His Metoprolol was lowered at that time as well from 75 mg to 50 mg BID. His PCP recommends he be admitted to the hospital.
Upon presentation to the hospital:
PMH:
HTN x 7 years
Type II DM
CAD s/p angioplasty 2 years ago
MI 3 years ago
EF = 60%
PVD s/p left femoral to posterior bypass
Hx of A Fib x 4 years
Medications:
Digoxin 0.25 mg QD KCl 40 mEq QD Vitamin C 500 mg QD
Diltiazem CD 180 mg QD ASA EC 325 mg QD Vitamin E 400 IU QD
Metoprolol 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache
Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD
Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID
HCTZ 12.5 mg QD Humalog 8u with meals
PE:
BP 110/50 Pulse 38 bpm Resp 14/min
Rest of physical exam unremarkable
Labs:
K+ 6.9 WBC 5,800/mm3
Na+ 135 Hct 35%
Cr 1.9 Dig 2.78
BUN 35 INR 2.3
Gluc 102