Prescribing For Older Adults and Pregnant Women

Depression is more common in adults than in children, and it has various negative impacts on people’s lives. Therefore, it is important for a PMPNP to have adequate knowledge concerning treatment and management approaches that can be used to improve patient outcomes. Various treatment approaches, both pharmacological and non-pharmacological approaches, exist for depression among older adults. One of the FDA-approved drugs for depression is Wellbutrin which is an atypical antidepressant (Arnold et al., 2021). Apart from FDA-approved medications, there are also off-label medications. One of the off-label medications is lithium, which though approved for bipolar disorder, is also used as an off-label strategy for depression (Undurraga et al.,2019). Apart from the pharmacological approaches, non-pharmacological approaches are used in the treatment of depression. One approach is the use of cognitive behavioral therapy to help patients manage their symptoms (O’moore et al., 2018).

Risk assessment is key in deciding on the treatment approaches to make. Therefore, I would consider if the patient has other comorbidities or if they are using other medications which can potentially interact with the medication to be prescribed. Wellbutrin as a medication for depression has various benefits, such as the lack of any known problems which come due to its long use. One risk associated with Wellbutrin is the risk of seizures. The use of lithium as an off-label depression medication has the benefit of the ability to fix chemical imbalances in the brain (Rybakowski et al., 2021). On the other hand, one risk associated with this medication is a feeling of metallic taste and diarrhea.

The negative impacts of depression have led to various efforts to contain the condition. One aspect is the use of clinical guidelines. A clinical practice guideline for depression was recently updated by the American Psychological Association. According to this guideline, the treatment of depression among older adults requires consideration of EBP elements, engaging in shar

Prescribing For Older Adults and Pregnant Women

ed decision-making for treatment selection, and setting the treatment goals (Molenaar et al., 2018). It also recommends the use antidepressants such as Wellbutrin in the treatment of older adults which has been discussed in this assignment. The guideline also supports the use of cognitive behavioral therapy as a psychotherapy approach, which also support what the recommended approach.

References

Arnold, M. J., Fulleborn, S., & Farrell, J. (2021). Medications for Treatment-Resistant Depression in Adults. American Family Physician, 103(1), 16-18. https://www.aafp.org/pubs/afp/issues/2021/0101/p16.html

Molenaar, N. M., Kamperman, A. M., Boyce, P., & Bergink, V. (2018). Guidelines on treatment of perinatal depression with antidepressants: An international review. Australian & New Zealand Journal of Psychiatry, 52(4), 320-327.https://doi.org/10.1177/0004867418762057

O’moore, K. A., Newby, J. M., Andrews, G., Hunter, D. J., Bennell, K., Smith, J., & Williams, A. D. (2018). Internet cognitive–behavioral therapy for depression in older adults with knee osteoarthritis: a randomized controlled trial. Arthritis Care &Research, 70(1), 61-70. https://doi.org/10.1002/acr.23257

Rybakowski, J. K. (2021). Lithium treatment in the era of personalized medicine. Drug Development Research, 82(5), 621-627.https://doi.org/10.1002/ddr.21660

Undurraga, J., Sim, K., Tondo, L., Gorodischer, A., Azua, E., Tay, K. H., … & Baldessarini, R. J. (2019). Lithium treatment for unipolar major depressive disorder: Systematic review. Journal of Psychopharmacology, 33(2), 167-176. https://doi.org/10.1177/0269881118822161

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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