ASSIGNMENT: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER

ASSIGNMENT: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER

ASSIGNMENT: COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER

Pharmacologic Options for the Treatment of Generalized Anxiety Disorder (GAD)
Anxiolytics are a group of drugs used in the treatment of generalized anxiety disorder. The different anxiolytics utilized include benzodiazepines, buspirone, anticonvulsants, antihistamines, and beta-adrenergic blockers. Benzodiazepines are the most commonly used drugs for GAD because of their high safety, efficacy, and acceptance level by the patients. The example of drugs in this class includes diazepam, oxazolam, nitrazepam, estazolam, and medazepam among others. The drugs work by increasing gama-aminobutyric acid in the central nervous system, which reduces anxiety levels. The plasma concentration of benzodiazepine is directly proportional to their concentration at the receptor sites. Their effects are also directly proportional to their plasma concentration at a level above the minimal effective concentration. Benzodiazepines have high protein binding with the drugs being 95% distributed in the body once distribution equilibrium has been achieved (Bounds & Nelson, 2023; Tucker, 2022). The routes of administration include intravenous, intramuscular, and oral. Benzodiazepines are metabolized in liver and excreted via the kidneys.
Anticonvulsants are also used for treating GAD. They also work by increasing the levels of gama-aminobutyric acid in the central nervous system. Pregabalin and Gapabentin are the most commonly used anticonvulsants, which are taken orally, with linear absorption and bioavailability dependent on the dose. Anticonvulsants are metabolized in the liver and excreted via the renal system. Buspirone is the other drug, which is an azapirone piperazine compound that moderates receptor affinity for dopamine and 5-HT1A receptor agonist. Buspirone is largely used for mild to moderate GAD. Its effects take weeks to be realized. Buspirone is administered orally, metabolized in the liver, and excreted in the kidneys (Skidmore-Roth, 2022). It has high drug interactions with tricyclic antidepressants, cimetidine, haloperidol, and benzodiazepines.
Beta-adrenergic drugs are the other class that works by inhibiting the actions of adrenaline and noradrenaline from acting on the beta adrenergic receptors in the sympathetic nervous system. They are administered orally, metabolized in the liver, and excreted through urine. The last category of drugs is antihistamines, which induce sleep and produce calmness in patients with GAD. They are administered orally, metabolized in liver, and excreted through the kidneys (Williams, 2022). Antihistamines are less effective as compared to benzodiazepines in the treatment of moderate and severe GAD.

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References
Bounds, C. G., & Nelson, V. L. (2023). Benzodiazepines. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470159/
Skidmore-Roth, L. (2022). Mosby’s 2023 Nursing Drug Reference—E-Book. Elsevier Health Sciences.
Tucker, R. G. (2022). 2023 Lippincott Pocket Drug Guide for Nurses. Lippincott Williams & Wilkins.
Williams, L. (2022). Nursing 2023 Drug Handbook. Amazon Digital Services LLC – KDP Print US.

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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.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the Resources for this module and 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.

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 disease.

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

BY DAY 3 OF WEEK 8

Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.

LEARNING RESOURCES

Required Readings

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Chapter 26, “Antipsychotic Agents and Their Use in Schizophrenia” (pp. 203–213)

Chapter 27, “Antidepressants” (pp. 214–226)

Chapter 28, “Drugs for Bipolar Disorder” (pp. 228–233)

Chapter 29, “Sedative-Hypnotic Drugs” (pp. 234–242)

Chapter 30, “Management of Anxiety Disorders” (pp. 243–247)

Chapter 31, “Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder” (pp. 248–254)

Required Media