Please review complete instructions on attached document.

**THIS DISCUSSION IS DIVIDE IN TWO PARTS –

1. MAIN DISCUSSION POST BY WEDNESDAY 10/20/2021 BEFORE 8:00 PM EST

2. TWO REPLIES BY FRIDAY 10/22/2021 BEFORE 8:00 PM EST


Discussion: Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder

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

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.


To Prepare

· 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.


Discussion Instructions:

· Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD (Generalized Anxiety Disorder).

· 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 the disease.

· Think about a personalized plan of care based on these influencing factors and patient history with GAD.

· Compare different treatment options that can be used.

· Use at least 5 references

· APA 7

**THIS DISCUSSION IS DIVIDE IN TWO PARTS

1.

MAIN DISCUSSION POST BY

WEDNESDAY

1

0/20

/2021

BEFORE 8:00 PM

EST

2.

TWO REPLIES BY FRIDA


Instructions:

Read a selection of your colleagues’ responses and respond to  your colleagues 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.

**minimum of three (3) scholarly references are required for each reply cited within the body of the reply & at the end**

Reply # 2

Chioma murphy 

Top of Form

My experience, and observations from the last 5 years and how pharmacokinetic and pharmacodynamic factors altered my patient’s response to a drug

Three years ago, I had a patient who was diagnosed with Generalized Anxiety Disorder (GAD) and was prescribed alprazolam (Xanax) a Benzodiazepines to manage his GAD. In the course of my discussion with this patient I found out that he never disclosed to his health provider, the actual amount of alcoholic drinks he consumed on a daily bases. The patient had lied to his health provider that he consumed about three to four beers a week. Whereas he actually drank up to 12 cans of beer in a night. He also received multiple prescriptions for alprazolam because he went to his health provider giving account of misplaced prescriptions and insisted on repeat prescriptions. 

The patient was received and admitted in a comatose state because he continued his regular drinking habit, after taking his prescribed alprazolam. According to the patient, on that evening of the incidence, he became very light headed, and dropped to the floor after concurrent consumption of alcoholic beverages and alprazolam. Patient was lucky because his neighbor walked in on him, and found him lying in a pool of his own blood, and then called 911.

How my patient’s behavior influenced the his pharmacokinetic and pharmacodynamic processes

Benzodiazepines are first-choice drugs for anxiety disorders because they produce immediate effects (Rosenthal, L. D., & Burchum, J. R., 2018). Benzodiazepines act by potentiating the inhibitory actives of the gamma-aminobutyric acid (GABA) neurotransmitter receptor binding at the interface of the GABA-A receptor (Kang,  M, et al., 2021). This action causes an increase of influx of chloride ions through the GABA ion channels, postsynaptic hyperpolarization, and ultimately decreasing the possibility of generating an action potential (Kang,  M, et al., 2021).

Benzodiazepines taken in therapeutic or toxic doses rarely causes a significant respiratory depression. Compared to other barbiturates, benzodiazepines have low incidence of respiratory depression because there are few binding sites in the brainstem where the respiratory center is located (Kang,  M, et al., 202


Instructions:

Read a selection of your colleagues’ responses and respond to  your colleagues 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.

**minimum of three (3) scholarly references are required for each reply cited within the body of the reply & at the end**

Reply # 1

Beatrice Saina 

Top of Form

Generalized Anxiety Disorder (GAD)

GAD is a long-term condition marked by overwhelming worry. GAD is the least likely of all anxiety disorders to remit. The majority of GAD patients also have another psychiatric condition, most commonly depression (Rosenthal & Burchum, 2021). GAD is characterized by unreasonable or excessive anxiety over a variety of events or activities, such as school or work accomplishment, that lasts for at least six months. Apprehension, vigilance, stress, poor attention, and problems becoming or maintaining sleep are some of the other psychological aspects. Muscle tension, restlessness, trembling, and symptoms of autonomic hyperactivity, such as tachycardia, palpitations, and sweating, are all somatic manifestations.

Prototype Drugs (Drugs for Anxiety Disorders) ​

· Benzodiazepine – Diazepam

· Nonbenzodiazepine-Nonbarbiturate – Buspirone.

Treatment

GAD can be treated with both non-drug and medication therapies. Cognitive behavioral therapy (CBT), supportive therapy, relaxation training, and biofeedback are examples of non-drug therapies. In anxiety-provoking events, these can help reduce symptoms and enhance coping skills. Nondrug therapy may be sufficient when symptoms are modest (Rosenthal & Burchum, 2021). Drugs, on the other hand, are appropriate if symptoms are really unpleasant or disabling. Benzodiazepines, buspirone, and four antidepressants (venlafaxine, duloxetine, paroxetine, and escitalopram) are among the first-line treatments for GAD now approved by the US Food and Drug Administration (FDA). Other medicines for the treatment of GAD are being used off-label, despite the fact that they are recommended. The benzodiazepines provide immediate relief. The onset of buspirone and antidepressants, on the other hand, is delayed. As a result, benzodiazepines are the medications of choice for quick anxiety relief, particularly when anxiety is intense. Buspirone and antidepressants, on the other hand, are preferable for long-term maintenance. Since GAD is a chronic condition, medication treatment should be continued for at least 12 months, if not longer. Regrettably, drug withdrawal typically leads to relapse, even after extensive treatment. As a result, medication the