Approaches To Manage the Patient Weight Concern – Unit 7 Case Study Discussion
This article covers Unit 7 Assignment – Case Study Discussion – Approaches To Manage the Patient Weight Concern and other discussion topics.
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Unit 7 Assignment – Case Study Discussion
Two Approaches To Manage the Patient Weight Concern
Case Overview
In the selected case scenario, the patient is a 47-year-old woman diagnosed with bipolar disorder and anxiety. For several years she has been prescribed duloxetine and quetiapine and has diabetes, hypertension, and hyperlipidemia as comorbidities. She also smokes and presents with being overweight and experiencing sexual dysfunctions. Part of a PMHNP is to evaluate, monitor, and manage psychotropic side effects in a safe way (Chen et al., 2018). Therefore, this post purposes of outlining a PMHNP’s approach to manage both the patient’s weight concern and sexual side effects that she is currently experiencing.
Two Approaches To Manage the Patient Weight Concern
To manage the psychotropic medication-induced weight gain, the PMHNP offering healthcare services could utilize non-pharmacological strategies like diet and exercises reinforced with pharmacological interventions Topiramate. Kim et al. (2020) note that dietary and exercise-based interventions combined with medication, specifically Topiramate, in this context can be used to achieve loss. Topiramate is a comparatively safe drug with minimal contraindications hence its choice. Likewise, to address the patient’s sexual dysfunction experiences would call prescribing either Bupropion or buspirone as off-label medication interventions for the 47-year-old patient with diminished libido induced by prescription antidepressants (Goldstein et al., 2017).
Approach to Managing the Sexual Dysfunction side Effects She is Experiencing
To manage the sexual dysfunction side effect that this patients continues to experience, I would introduce bupropion or mirtazapine. Bupropion according to Lorenz et al(2017) as an antidepressant has better adverse side effect profile making it the treatment of choice as the woman in context has expressed concern about her sexual performance. However, the decision to introduce bupropion will follow a practitioner – patient discussion to identify what strategies the patient has already tried since there exists a probability the patient has measures that are potentially effective and only needs reassurance to continue.
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Connecticut(CT) PMHNP Prescribing Laws
While not prescribing additional medications, Connecticut is one of the 28 states in the US where qualified Nurse Practitioners only practice full practice authority after practicing under physician oversight for thirty-six months and two thousand hours. CT recognizes advanced practice nurses as primary care providers ad after meeting the mandatory requirements while collaborating with a physician are allowed to [prescribe, dispense , and administer medicines. The medications that the PMHNP can administer include Schedule V controlled substances as expressly outlined in their written collaborative agreement.
Antidepressants interfere with serotonin, the anxiety and mood regulating neurotransmitter that may increase cravings for carbohydrate-rich nutrition intake. The post also emphasizes the development of SD in depression patients could be caused by antidepressant prescribing as anything that interferes with serotonin, dopamine, and norepinephrine is bound to interfere with the sexual functioning physiology. Therefore, the PMHNP has the responsibility to devise medication and non-medication measures to resolve weight gain and SD to enhance antidepressant medication adherence.
References
Chen, C. Y. A., Chiu, Y. H., & Shen, W. W. (2018). Drug augmentation for treatment-refractory major depressive disorder. Taiwanese Journal of Psychiatry (Taipei) Vol, 32(3).
Kim, S. Y., Park, E. S., & Kim, H. W. (2020). Effectiveness of Non-Pharmacological Interventions for Overweight or Obese Infertile Women: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 17(20), 7438.
Goldstein, I., Kim, N. N., Clayton, A. H., DeRogatis, L. R., Giraldi, A., Parish, S. J., … & Worsley, R. (2017, January). Hypoactive sexual desire disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) expert consensus panel review. In Mayo clinic proceedings (Vol. 92, No. 1, pp. 114-128). Elsevier.
Montejo, A. L., Prieto, N., de Alarcón, R., Casado-Espada, N., de la Iglesia, J., & Montejo, L. (2019). Management strategies for antidepressant-related sexual dysfunction: a clinical approach. Journal of clinical medicine, 8(10), 1640.
Lorenz, T., Rullo, J., & Faubion, S. (2016, September). Antidepressant-induced female sexual dysfunction. In Mayo Clinic Proceedings (Vol. 91, No. 9, pp. 1280-1286). Elsevier.