NURS 6521 Week 8 discussion : Decision Making When Treating Psychological Disorders

NURS 6521 Week 8 discussion

For this Discussion, you will select an interactive media piece to practice decision-making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine the potential impacts of pharmacotherapeutics on a patient’s pathophysiology. NURS 6521 Week 8 discussion

To Prepare

Review this week’s interactive media pieces and select one to focus on for this Discussion.
Reflect on the decision steps in the interactive media pieces, and consider the potential impacts of the administration of the associated pharmacotherapeutics on the patient’s pathophysiology

By Day 3 of Week 8

Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples. NURS 6521 Week 6 discussion

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 who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Review the interactive media piece assigned. http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html

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NURS 6521 Week 8 discussion Sample Solution

Discussion: Decision Making When Treating Psychological Disorders

The selected psychological disorder is complex regional pain disorder (CRPD). The main symptom of CRPD is pain that normally develops after the extremities sustain an injury and the pain normally lasts for more than 6 months (Shim et al., 2019). The pain is normally in the deep tissue and increases with movement and temperature changes. There is reduced muscle strength and movement avoidance. The pain is indicative of damage or injury to the central nervous system (CNS) or peripheral system. CRPS is typified by pain, trophic abnormalities, psychological distress, cutaneous vasomotor changes, and motor abnormalities (Birklein & Dimova, 2017).

The decision steps applied to complete the interactive media piece for CRPD involved selecting the most effective and appropriate treatment option for CRPD. Specifically, the medication (Amitriptyline) effective in treating neuropathic pain such as CRPD was selected. Amitriptyline is a tricyclic antidepressant that treats neuropathic pain (Moore et al., 2015). Other available options were not selected because they are analgesics not effective in improving neuropathic pain. NURS 6521 Week 8 discussion

The selected pharmacotherapeutic was Amitriptyline. Amitriptyline is a tricyclic antidepressant (TCA) and it affects numerous targets and has pleiotropic effects and which contributes to the medication’s efficacy in treating neuropathic pain such as CRPD (Fornasari, 2017). For example, amitriptyline is a local anesthetic that blocks voltage-gated sodium channels. The medication is also an antidepressant that modulates the immune system; the immune system plays a major role in neuropathic pain. Additionally, TCAs like amitriptyline has a direct effect on the central sensitization where the medication blocks NMDA receptors within the spinal cord (Obata, 2017). Amitriptyline thus has the ability to potentiate the activity of the descending inhibitory pathways that extend from the brain stem to the spinal cord, mostly by hindering the reuptake of noradrenaline and serotonin and thus relieving the pain. Amitriptyline can also hinder the synaptic transmission between neurons and trigger the release of inhibitory substances like gamma-aminobutyric acid (GABA) or endogenous opioids, therefore relieving the pain.

The potential of Amitriptyline to treat neuropathic pain through multiple targets informed the selection of the medication for this patient (Obata, 2017). For example, Amitriptyline will inhibit the neuropathic pain for this patient by elevating the level of noradrenaline within the spinal cord, and by acting on the locus coeruleus, thus directly inhibiting pain. Noradrenaline is very effective in hindering neuropathic pain. The mediation also increases 5-HT and dopamine within the CNS and may improve the inhibitory effects of noradrenaline auxiliary (Lawson, 2017). Therefore, the efficacy of Amitriptyline in treating neuropathic pain informed the treatment plan for this patient.

References

Birklein, F., & Dimova, V. (2017). Complex regional pain syndrome up to date. Pain reports, 2(6), e624. https://doi.org/10.1097/PR9.0000000000000624.

Fornasari D. (2017). Pharmacotherapy for Neuropathic Pain: A Review. Pain and therapy, 6(Suppl 1), 25–33. https://doi.org/10.1007/s40122-017-0091-4.

Lawson K. (2017). A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia. Biomedicines, 5(2), 24. https://doi.org/10.3390/biomedicines5020024

Moore, R. A., Derry, S., Aldington, D., Cole, P., & Wiffen, P. J. (2015). Amitriptyline for neuropathic pain in adults. The Cochrane database of systematic reviews, 2015(7), CD008242. https://doi.org/10.1002/14651858.CD008242.pub3.

Obata H. (2017). Analgesic Mechanisms of Antidepressants for Neuropathic Pain. International journal of molecular sciences, 18(11), 2483. https://doi.org/10.3390/ijms18112483.

Shim, H., Rose, J., Halle, S., & Shekane, P. (2019). Complex regional pain syndrome: a narrative review for the practicing clinician. British journal of anesthesia, 123(2), e424–e433. https://doi.org/10.1016/j.bja.2019.03.030