NRNP 6675 Week 9 Prescribing for Older Adults and Pregnant Women Assignment

NRNP 6675 Week 9 Prescribing for Older Adults and Pregnant Women Assignment

Prescribing for Older Adults and Pregnant Women

Narcolepsy is a chronic disorder of sleep characterized by excessive daytime sleepiness, cataplexy, and disrupted sleep-wake cycles (Boland & Verduin, 2022). The management of narcolepsy in the elderly involves consideration of their comorbidities, polypharmacy, and altered pharmacokinetics. This paper describes evidence-based treatment options for narcolepsy in the elderly, including one FDA-approved medication, one off-label treatment option, and one nonmedical treatment option, as well as associated risks and considerations of guidelines.

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Treatment Recommendations

            Modafinil has FDA approval for treating narcolepsy; it improves alertness and can be used to manage excessive daytime sleepiness (Chin et al., 2024). Methylphenidate (a stimulant) is another drug that may be useful in treating narcolepsy, but it is not considered first-line therapy because it is not FDA-approved for this use (Manalo & Attarian, 2025). One nonpharmacological therapy for the management of narcolepsy consists of scheduled daytime sleep combined with sleep hygiene education to improve the function of individuals with narcolepsy and decrease the severity of their symptoms (Jiang et al., 2025).

Risk Assessment

The assessment for risk includes reviewing the cardiovascular health, cognition, fall risk, and the possibility of drug interactions. According to Chin et al. (2024), modafinil has a lower potential for abuse than other drugs and has a lower risk of developing cardiovascular-related illnesses from its use, but it can still cause insomnia and anxiety. The use of methylphenidate can provide more stimulating effects than modafinil; however, it has much greater risk factors, like developing hypertension or having an arrhythmia and developing a dependency (Manalo & Attarian, 2025). All risks must be weighed against benefits, especially in the elderly with multiple co-existing medical problems.

Guideline Considerations

            According to clinical protocols from various organizations (such as the American Academy of Sleep Medicine), wake-promoting agents (like modafinil) are to be used as the first treatment for individuals with narcolepsy (Jiang et al., 2025). There are no distinct age-related protocols for older adults using these agents; however, treatment principles remain similar, with additional precautions regarding safety. Therefore, since there are no specific age-related protocols, when formulating treatment plans for older adults, clinicians should take into consideration pharmacokinetic/cardiac factors, comorbid conditions, and patient preferences.

Conclusion

            An individualized, well-balanced method is needed to treat older adults with narcolepsy by utilizing both pharmacological and non-pharmacological methods. Modafinil is still typically considered first-line therapy for narcolepsy; however, some off-label stimulant medications, such as methylphenidate, may also be helpful; therefore, consider using these cautiously. Incorporating behavioral measures will help produce the best outcome and still allow for the least amount of risk, assuring that this population is managed effectively and safely.

References

Boland, R., & Verduin, M. (2022). Kaplan & Sadock’s Synopsis of Psychiatry. (12th ed.). Wolters Kluwer Medical.

Chin, W., Huang, Y., Lam, N. Y. T., Mak, K. Y., Tang, I., Wang, C., & Lin, C. (2024). Effects of modafinil on nocturnal sleep patterns in patients with narcolepsy: A cohort study. Sleep Medicine, 119, 95–102. https://doi.org/10.1016/j.sleep.2024.04.024

Jiang, R. Y., Duka, S., & Vendrame, M. (2025). Spotlight on Seniors with Narcolepsy: Comorbidities and Management. Journal of Clinical Medicine, 14(9), 3217. https://doi.org/10.3390/jcm14093217

Manalo, N. C., & Attarian, H. (2025). Aging with narcolepsy: understanding the unique challenges for older adults. In Elsevier eBooks (pp. 173–194). https://doi.org/10.1016/b978-0-443-30004-2.00010-9

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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

 

Learning Resources

Required Readings

Required Media

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

NRNP_6675_Week9_Discussion_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Main Posting:Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 44 to >39.0 pts Excellent 90%–100% Thoroughly responds to the Discussion question(s)… Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources… No less than 75% of post has exceptional depth and breadth… Supported by at least three current credible sources

39 to >34.0 pts Good 80%–89% Responds to most of the Discussion question(s)… Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module… 50% of the post has exceptional depth and breadth… Supported by at least three credible references

34 to >30.0 pts Fair 70%–79% Responds to some of the Discussion question(s)… One to two criteria are not addressed or are superficially addressed… Is somewhat lacking reflection and critical analysis and synthesis… Somewhat represents knowledge gained from the course readings for the module… Post is supported by fewer than two credible references

30 to >0 pts Poor 0%–69% Does not respond to the Discussion question(s)… Lacks depth or superficially addresses criteria… Lacks reflection and critical analysis and synthesis… Does not represent knowledge gained from the course readings for the module… Contains only one or no credible references

 44 pts
This criterion is linked to a Learning Outcome Main Posting:Writing 6 to >5.0 pts Excellent 90%–100% Written clearly and concisely… Contains no grammatical or spelling errors… Adheres to current APA manual writing rules and style

5 to >4.0 pts Good 80%–89% Written concisely… May contain one to two grammatical or spelling errors… Adheres to current APA manual writing rules and style with minor errors

4 to >3.0 pts Fair 70%–79% Written somewhat concisely… May contain more than two spelling or grammatical errors… Contains some APA formatting errors

3 to >0 pts Poor 0%–69% Not written clearly or concisely… Contains more than two spelling or grammatical errors… Does not adhere to current APA manual writing rules and style

 6 pts
This criterion is linked to a Learning Outcome Main Posting:Timely and full participation 10 to >8.0 pts Excellent 90%–100% Meets requirements for timely, full, and active participation… Posts main Discussion by due date

8 to >7.0 pts Good 80%–89% Posts main Discussion by due date… Meets requirements for full participation

7 to >6.0 pts Fair 70%–79% Posts main Discussion by due date

6 to >0 pts Poor 0%–69% Does not meet requirements for full participation… Does not post main Discussion by due date

 10 pts
This criterion is linked to a Learning Outcome First Response:Post to colleague’s main post that is reflective and justified with credible sources 9 to >8.0 pts Excellent 90%–100% Response exhibits critical thinking and application to practice settings… Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 pts Good 80%–89% Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 pts Fair 70%–79% Response is on topic, may have some depth.

6 to >0 pts Poor 0%–69% Response may not be on topic, lacks depth.

 9 pts
This criterion is linked to a Learning Outcome First Response:Writing 6 to >5.0 pts Excellent 90%–100% Communication is professional and respectful to colleagues…. Response to faculty questions are fully answered, if posed…. Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in standard, edited English.

5 to >4.0 pts Good 80%–89% Communication is mostly professional and respectful to colleagues…. Response to faculty questions are mostly answered, if posed…. Provides opinions and ideas that are supported by few credible sources… Response is written in standard, edited English.

4 to >3.0 pts Fair 70%–79% Response posted in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.

3 to >0 pts Poor 0%–69% Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.

 6 pts
This criterion is linked to a Learning Outcome First Response:Timely and full participation 5 to >4.0 pts Excellent 90%–100% Meets requirements for timely, full, and active participation… Posts by due date

4 to >3.0 pts Good 80%–89% Meets requirements for full participation… Posts by due date

3 to >2.0 pts Fair 70%–79% Posts by due date

2 to >0 pts Poor 0%–69% Does not meet requirements for full participation… Does not post by due date

 5 pts
This criterion is linked to a Learning Outcome Second Response:Post to colleague’s main post that is reflective and justified with credible sources 9 to >8.0 pts Excellent 90%–100% Response exhibits critical thinking and application to practice settings…. Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 pts Good 80%–89% Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 pts Fair 70%–79% Response is on topic, may have some depth.

6 to >0 pts Poor 0%–69% Response may not be on topic, lacks depth.

 9 pts
This criterion is linked to a Learning Outcome Second Response:Writing 6 to >5.0 pts Excellent 90%–100% Communication is professional and respectful to colleagues…. Response to faculty questions are fully answered, if posed…. Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in standard, edited English.

5 to >4.0 pts Good 80%–89% Communication is mostly professional and respectful to colleagues…. Response to faculty questions are mostly answered, if posed…. Provides opinions and ideas that are supported by few credible sources… Response is written in standard, edited English.

4 to >3.0 pts Fair 70%–79% Response posed in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.

3 to >0 pts Poor 0%–69% Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.

 6 pts
This criterion is linked to a Learning Outcome Second Response:Timely and full participation 5 to >4.0 pts Excellent 90%–100% Meets requirements for timely, full, and active participation… Posts by due date

4 to >3.0 pts Good 80%–89% Meets requirements for full participation… Posts by due date

3 to >2.0 pts Fair 70%–79% Posts by due date

2 to >0 pts Poor 0%–69% Does not meet requirements for full participation… Does not post by due date

 5 pts

Total Points: 100

 

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