How does an advanced practice nurse determine the best treatment option or pharmacotherapeutic to recommend for patients with psychological disorders?

The Decision Tree for Anxiety Disorders is one of the selected interactive media pieces for the discussion. Generalized Anxiety Disorder (GAD) is the psychological disorder. It involves determining how severe the anxiety is, diagnosing the need to prescribe medication and monitoring the patient’s response.

If the symptoms of anxiety are extreme, medications may be necessary based on these steps. Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) are the recommended pharmacotherapeutics for GAD. SSRIs boost serotonin in the brain and block its reuptake. SNRIs, on the other hand, reduce serotonin. Side effects of both medications include nausea, headaches, insomnia, sexual dysfunction, and even sleeplessness.

The administration of SSRIs or SNRIs may impact the patient’s pathophysiology by altering the serotonin and norepinephrine levels in the brain. These medications may increase serotonin neurotransmission and decrease anxiety symptoms. However, there may be potential impacts on the patient’s endocrine system, cardiovascular system, and gastrointestinal system due to the medication’s mechanism of action.

To suggest treatment plans for the patient, the potential impacts of pharmacotherapeutics on the patient’s pathophysiology must be considered. Patients with diabetes or a history with cardiovascular disease may require a medication that has fewer metabolic and cardiovascular side effects. A medication may be more effective for patients who have had kidney damage or problems.

References:

American Psychiatric Association. (2013). Fifth edition.). https://doi.org/10.1176/appi.books.9780890425596

National Institute for Mental Health. (2018). 2018 Generalized Anxiety Disorder. https://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier.

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