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explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse

Short Answer Assessment

  1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?

The appropriate drug therapy for MDD with co-occurring alcohol abuse includes a combination of naltrexone and sertraline (an SSRI medication). Studies show that the combined treatment contributes to higher alcohol abstinence rates, prolonged time to drinking relapse, and improved mood compared to those who receive either antidepressant or alcohol abuse pharmacologic intervention alone (McHugh & Weiss, 2019). Antidepressants like Bupropion are contraindicated since it lowers seizure threshold when used in a patient with a predisposition to seizures related to alcohol withdrawal. Patients on combined naltrexone and sertraline can expect improvement in symptoms 2-6 weeks after starting therapy.

  1. List 4 predictors of late onset generalized anxiety disorder.

The predictors of late-onset GAD are:

explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse
explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse
  1. Female sex.
  2. Occurrence of adverse life events, like the ending of a relationship, illness, or death of a loved one (Subramanyam et al., 2018).
  • Being diagnosed with a chronic disease.
  1. Low-income levels or poverty.

 

  1. List 4 potential neurobiology causes of psychotic major depression.

Neurobiology factors associated with Psychotic major depression include:

  1. Neutotransmitter abnormalities: Decrease in levels of serotonin and norepinephrine (Kaltenboeck & Harmer, 2018).
  2. Neuroendocrine disturbances: Hyperactivity of the hypothalamic-pituitary-adrenal cortical axis causes increased cortisol levels as a result of increase Corticotrophin-releasing hormone (CRH) which lead to elevated Adrenocorticotropic Hormone (Kaltenboeck & Harmer, 2018).
  • Structural brain abnormalities: Reduced size of Prefrontal cortex and Hippocampus.
  1. Dysfunction of the immune system: Increaseed levels of inflammatory biomarkers like tumor necrosis factor, C-reactive protein, and interleukins.
  1. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.

Five symptoms that should be present to diagnose a major depression episode include: Depressed mood, Shed interest or pleasure in most activities, Sleep disturbances, Low energy levels of increased fatigue, and appetite disturbances (Kaltenboeck & Harmer, 2018).

  1. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific. 

Drug classes that cause insomnia include:

  1. Cholinesterase Inhibitors like Rivastigmine.
  2. Beta Agonists like Metoprolol (Krystal et al., 2019)
  • Selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine.

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Lopes Write Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource