NURS 6630 WEEK 8 ASSIGNMENT 1 QUESTION AND ANSWERS

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 This study source was downloaded by from CourseH on :31:29 GMT -05:00 3 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 This study source was downloaded by from CourseH on :31:29 GMT -05:00 4  Extended episodes of anxiety  Excessive conflict in relationships  Sexual functioning problems, and  Increased alcohol intake and other substances (Sateia et al., 2