A patient is being seen at your clinic for depression and has been prescribed Zoloft. At today's visit, she admits to still taking St. John's Wort. What do you tell her?
It is revealed that St. John's wort is an antidepressant drug, thus supporting the idea of telling the patient to stop taking one of medication; especially St. John's wort will be of the essence. The use of two antidepressants with the same working mechanism of raising the serotonin levels in the brain is likely to build serotonin to unhealthy levels. This may lead to Serotonin syndrome, which is associated with heart problems, shivering, and anxiety symptoms.
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A patient asks if they would benefit from taking Aricept from their mild dementia. What is your response?
There are benefits associated with the use of Aricept for mild dementia, including the stabilization of cognitive performance and the ability to sustain daily living activities. This is because Aricept is a cholinesterase inhibitor. It can prevent acetylcholinesterase from breaking down acetylcholine (Birks & Harvey, 2018). Therefore, it is the approved pharmacological treatment for patients with mild to severe dementia (Birks & Harvey, 2018). However, as pointed out, patients should be informed that there are insignificant therapeutic effects associated with the drug.
Your patient asks if he or she should take Propranolol at the beginning of a migraine headache. How do you respond?
One should not take Propranolol, Inderal at the beginning of migraine headache as the drug is meant for prevention of headache occurrence since they fall in a broad group of medications known as Oral Migraine Prevention Medications, OMPMs (Doherty, 2019). Instead, the patient should take an analgesic given that signs and symptoms of headache or migraine are already in existence just as noted.
Discussion Response #2
A patient asks if they would benefit from taking Aricept from their mild dementia. What is your response?
It is revealed that Aricept only benefits patients whose condition of dementia is as a result of Alzheimer's disease. Aricept, as an Acetylcholinesterase inhibitor it enhances the function of nerve cells in the brain (Birks & Harvey, 2018). This prevents the breakdown of acetylcholine, thus improving cognitive functions.
Your patient asks if they would be from taking Propranolol at the beginning of a migraine. How do you respond?
It is of the essence to note that propranolol helps to avert migraine headaches using a mechanism that blocks adrenaline, the hormone responsible for causing headaches (Doherty, 2019). Meaning, once the adrenaline hormone has been realized, it cannot be blocked; hence propranolol is ineffective once migraines have started.
A patient requires treatment for his ADHD but is drug tested at his job, and they have a zero-tolerance policy. Is there a medication he can take to help his attention and focus?
Stimulant drugs are the primary targets for drug testing at jobs. Therefore for such situations, he should opt for non-stimulant medications such as Guanfacine extended-release (Intuniv), atomoxetine, Clonidine extended-release (Kapvay, Jenloga), bupropion and tricyclic drugs (Bhat & Hechtman, 2016).
What is the most commonly used dopaminergic drug used for Parkinson's?
It is essential to control the symptoms of Parkinson's, particularly in slow actions and taut rigid body parts. This is achieved by using commonly used dopaminergic drugs such as entacapone and levodopa.
What other disorders are many of the Antiepileptic drugs used for? Name 2 of the drugs.
As noted by Perucca (2018), antiepileptic drugs are prescribed for the treatment of neuropathic pain, bipolar, and epilepsy, and disorders. The commonly used Antiepileptic drugs include Carbamazepine, valproate, and Lamotrigine.
References
Bhat, V., & Hechtman, L. (2016). Considerations in selecting pharmacological treatments for attention deficit hyperactivity disorder. Clinical Pharmacist. Retrieved from https://www.pharmaceutical-journal.com/research/review-article/considerations-in-selecting-pharmacological-treatments-for-attention-deficit-hyperactivity-disorder/20200602.article?firstPass=false
Birks, J. S., & Harvey, R. J. (2018). Donepezil for dementia due to Alzheimer's disease. Cochrane Database of Systematic Reviews. Retrieved from https://www.cochrane.org/CD001190/DEMENTIA_donepezil-people-dementia-due-alzheimers-disease
Doherty, C. (2019). Propranolol for Migraine Prevention. Retrieved from https://www.verywellhealth.com/propranolol-for-migraine-treatment-4172827
Perucca, E. (2018). From clinical trials of antiepileptic drugs to treatment. Epilepsia open, 3, 220-230.
Schimelpfening, N. (2020, February 4). Does St. John's Wort Have Any Drug Interactions With Antidepressants? Retrieved from https://www.verywellmind.com/st-johns-wort-drug-interactions-with-antidepressants-1066686
Zahoor, N., Shafi, A., & Haq, E. (2018). Chapter 7 Pharmacological Treatment of Parkinson’s Disease. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK536726/
