NRNP 6675 WEEK 9 Prescribing for Older Adults and Pregnant Women

NRNP 6675 WEEK 9 Prescribing for Older Adults and Pregnant Women

Prescribing For Older Adults and Pregnant Women

Both pharmacological and non-pharmacological approaches are effective in the treatment and management of various mental health complications. However, special populations such as pregnant women and older adults may require special considerations before a particular medication is prescribed to help manage their condition. Therefore, this discussion focuses on depression among older adults. Both pharmacological and non-pharmacological approaches have been used to treat and manage depression among older adults. Both FDA-Approved and over-the-counter medications are currently being used. One of the approved FDA-approved medications currently being used is Wellbutrin, which is an atypical antidepressant (Parish et al.,2023). On the other hand, lithium has also been used as an off-label medication for depression even though it has been approved by the FDA to treat bipolar disorder (Riedinger et al.,2023). As earlier indicated, non-pharmacological approaches have also been used. For example, cognitive behavioral therapy has been shown to be effective in the treatment and management of depression among older adults (Ciharova et al.,2023).

Administration of the medication requires a consideration of risk factors through a risk assessment. Therefore, in older adults, it is vital to assess whether the patient has other comorbidities since they are usually susceptible to more conditions. The implication is that there will be a need to inquire if the patient is using other medications to help prevent potential drug interactions. The discussed FDA-approved medication (Wellbutrin) has various benefits. For example, unlike other antidepressants, it does not cause weight gain, and it is also an effective antidepressant (Parish et al.,2023). However, there is a risk of seizures when using it. One of the benefits of lithium is that it is effective in treating brain chemical imbalances. On the other hand, it can cause diarrhea and an unpleasant metallic taste feeling. Currently, there are guidelines for depression; one of them is the American Psychological Association (Moshe et al.,2021). According to the American Psychological Association, antidepressants should be used as the firs line of pharmacological treatment. This recommendation supports the use of suggested Wellbutrin as an FDA-approve medication for depression (Parish et al.,2023). In addition, this guideline also recommends the use of physiotherapy approaches such as cognitive behavioral therapy which has also been proposed.

References

Ciharova, M., Furukawa, T. A., Efthimiou, O., Karyotaki, E., Miguel, C., Noma, H., … & Cuijpers, P. (2021). Cognitive restructuring, behavioral activation and cognitive-behavioral therapy in the treatment of adult depression: A network meta-analysis. Journal of Consulting and Clinical Psychology, 89(6), 563. https://doi.org/10.1037/ccp0000654

Moshe, I., Terhorst, Y., Philippi, P., Domhardt, M., Cuijpers, P., Cristea, I., … & Sander, L. B. (2021). Digital interventions for the treatment of depression: A meta-analytic review. Psychological Bulletin, 147(8), 749. https://psycnet.apa.org/doi/10.1037/bul0000334

Parish, A. L., Gillis, B., & Anthamatten, A. (2023). Pharmacotherapy for depression and anxiety in the primary care setting. The Journal for Nurse Practitioners, 19(4), 104556. https://doi.org/10.1016/j.nurpra.2023.104556

Riedinger, M. A., van der Wee, N. J., Giltay, E. J., & de Leeuw, M. (2023). Lithium in bipolar depression: A review of the evidence. Human Psychopharmacology: Clinical and Experimental, 38(5), e2881. https://doi.org/10.1002/hup.2881

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Prescribing for Older Adults and Pregnant Women

After assessing and diagnosing a patient, PMHNPs must take into consideration special characteristics of the patient before determining an appropriate course of treatment. For pharmacological treatments that are not FDA-approved for a particular use or population, off-label use may be considered when the potential benefits could outweigh the risks.

In this Discussion, you will investigate a specific disorder and determine potential appropriate treatments for when it occurs in an older adult or pregnant woman.

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:

• Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5-TR to use.
• Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label” drug, and one nonpharmacological intervention for treating the disorder in that population.

By Day 3 of Week 9

• Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.
• Explain the risk assessment you would use to inform your treatment decision  making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
• Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
• Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.

Upload a copy of your discussion writing to the draft Turnitin for plagiarism check.  Your faculty holds the academic freedom to not accept your work and grade at a zero if your work is not uploaded as a draft submission to Turnitin as instructed.

Read a selection of your colleagues’ responses.

By Day 6 of Week 9

Respond to at least two of your colleagues on 2 different days who selected different disorders. Propose an alternative on-label, off-label, or nonpharmacological treatment for the disorders. Justify your suggestions with at least two references to the literature.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

NRNP_6675_Week9_Discussion_Rubric