WEEK 8 DISCUSSION: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER WALDEN UNIVERSITY

WEEK 8 DISCUSSION: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER WALDEN UNIVERSITY

WEEK 8 DISCUSSION: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER WALDEN UNIVERSITY

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 nurses responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.

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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.

BY DAY 6 OF WEEK 8

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD. In addition, suggest different treatment options you would suggest to treat a patient with the topic of discussion.

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!

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NURS_6521_Week8_Discussion_Rubric

NURS_6521_Week8_Discussion_Rubric

CriteriaRatingsPtsThis criterion is linked to a Learning Outcome

Main Posting50 to >44.0 pts

Excellent

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. …Supported by at least three current, credible sources….Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

44 to >39.0 pts

Good

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. …At least 75% of post has exceptional depth and breadth. …Supported by at least three credible sources….Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

39 to >34.0 pts

Fair

Responds to some of the discussion question(s). …One or 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 cited with two credible sources….Written somewhat concisely; may contain more than two spelling or grammatical errors. …Contains some APA formatting errors.

34 to >0 pts

Poor

Does not respond to the discussion question(s) adequately….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 sources….Not written clearly or concisely. …Contains more than two spelling or grammatical errors. …Does not adhere to current APA manual writing rules and style.

50 pts

This criterion is linked to a Learning Outcome

Main Post: Timeliness10 pts

Excellent

Posts main post by day 3

0 pts

Poor

Does not post by day 3

10 pts

This criterion is linked to a Learning Outcome

First Response18 to >16.0 pts

Excellent

Response exhibits synthesis, critical thinking, and application to practice settings. …Responds fully to questions posed by faculty. …Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. …Demonstrates synthesis and understanding of learning objectives….Communication is professional and respectful to colleagues. ….Responses to faculty questions are fully answered, if posed. …Response is effectively written in standard, edited English.

16 to >14.0 pts

Good

Response exhibits synthesis, critical thinking, and application to practice settings. …Responds fully to questions posed by faculty. …Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. …Demonstrates synthesis and understanding of learning objectives….Communication is professional and respectful to colleagues. ….Responses to faculty questions are fully answered, if posed. …Response is effectively written in standard, edited English.

14 to >12.0 pts

Fair

Response is on topic and may have some depth….Responses posted in the discussion may lack effective professional communication. …Responses to faculty questions are somewhat answered, if posed. …Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

12 to >0 pts

Poor

Response may not be on topic and lacks depth….Responses posted in the discussion lack effective professional communication. …Responses to faculty questions are missing. …No credible sources are cited.

18 pts

This criterion is linked to a Learning Outcome

Second Response17 to >15.0 pts

Excellent

Response exhibits synthesis, critical thinking, and application to practice settings….Responds fully to questions posed by faculty. …Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. …Demonstrates synthesis and understanding of learning objectives….Communication is professional and respectful to colleagues. ….Responses to faculty questions are fully answered, if posed. …Response is effectively written in standard, edited English.

15 to >13.0 pts

Good

Response exhibits critical thinking and application to practice settings….Communication is professional and respectful to colleagues. …Responses to faculty questions are 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.

13 to >11.0 pts

Fair

Response is on topic and may have some depth….Responses posted in the discussion may lack effective professional communication. …Responses to faculty questions are somewhat answered, if posed. …. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

11 to >0 pts

Poor

Response may not be on topic and lacks depth….Responses posted in the discussion lack effective professional communication. …Responses to faculty questions are missing. …No credible sources are cited.

17 pts

This criterion is linked to a Learning Outcome

Participation5 pts

Excellent

Meets requirements for participation by posting on three different days.

0 pts

Poor

Does not meet requirements for participation by posting on 3 different days

5 pts

Total Points: 100

WEEK 8 DISCUSSION: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER WALDEN UNIVERSITY Sample

Anxiolytics are used to treat GAD and other anxiety disorders like social anxiety disorder and panic disorder. Anxiolytics include Benzodiazepines, Barbiturates, and Buspirone. The primary action of anxiolytics is to facilitate the effects of GABA and antagonism at ACh-N receptors. Besides, they also act on the brain’s dopaminergic pathways. Chen et al. (2018) explain that Centrally‐acting anxiolytic drugs, like benzodiazepines, barbiturates, and gabapentinoids, affect several CNS functions. This reflects their anxiolytic effects as well as their side effects like postural instability, sedation, and visuomotor and memory impairment.

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The target for benzodiazepine actions is the GABAA receptors. GABA is the major inhibitory neurotransmitter in the CNS. The binding of GABA to its receptor triggers an opening of a chloride channel, which causes an increase in chloride conductance. Barbiturates interact with GABAA receptors and enhance GABAergic transmission (Garakani et al., 2020). They potentiate GABA action on chloride entry into the neuron by prolonging the duration of the chloride channel openings. They can also block excitatory glutamate receptors. Buspirone has an efficacy comparable to that of benzodiazepines. Its action is mediated by serotonin receptors, and it displays some affinity for dopamine.

The first-line drug therapy for GAD includes Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). They are recommended as first-line therapy owing to their favorable risk-benefit ratio (Stein, 2021). Although Benzodiazepines have a fast onset, they are not recommended for monotherapy because they are associated with physiologic and psychologic dependence and are instead used as adjuncts to SSRIs. Tricyclic antidepressants have similar efficacy to Benzodiazepines in treating GAD. Nonetheless, their use is limited due to the slow onset of anxiolytic action and clinical adverse effects.

References

Chen, X., Broeyer, F., de Kam, M., Baas, J., Cohen, A., & van Gerven, J. (2018). Pharmacodynamic response profiles of anxiolytic and sedative drugs. British journal of clinical pharmacology, 83(5), 1028–1038. https://doi.org/10.1111/bcp.13204

Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options. Frontiers in psychiatry, 1412. doi: 10.3389/fpsyt.2020.595584

Stein, D. J. (2021). Evidence-Based Pharmacotherapy of Generalised Anxiety Disorder: Focus on Agomelatine. Advances in Therapy, 38(2), 52-60. https://doi.org/10.1007/s12325-021-01860-1