Pharmacotherapy for Neurological Disorders Essay

Posted: November 5th, 2022

Pharmacotherapy for Neurological Disorders Essay

The topic of learning for the discussion board is about the pharmacology of neurological disorders. Here are some items you will need to include in your initial discussion board posting: Include one of the factors (genetics, gender, ethnicity, age or behavior) A brief description of your selected neurological disorder in your write up. Make sure you clearly state your factor in your initial discussion board posting. Your care plan for your virtual patient must be specific (drug, dose, frequency), contain goals of your therapy, concise and in the SOAPE format. If your care plan were part of the patient’s health history chart, other healthcare providers (dietary, PT/OT, nursing, medicine and pharmacy) will be reading this information and making decisions based on the information you provide. Pharmacotherapy for Neurological Disorders Essay

Discussion: Pharmacotherapy for Neurological Disorders

Sleep Disorders

Sleep disorders encompass problems with the quantity, quality and timing of the sleep which results to distress and functioning problems during the daytime. Sleep problems are associated with emotional and physical problems and they can significantly contribute to or worsen mental health conditions (American Psychiatric Association, 2013). For instance, a sleep disorder can be an indication of a neurological problem such as Parkinson’s disease. Diagnosis of sleep disorders is performed through broad evaluation, and this may involve taking a comprehensive patient history, physical examination, examining sleep diaries, interviewing as well as through clinical testing. Among the most common sleep disorders is insomnia. Pharmacotherapy for Neurological Disorders Essay . Insomnia is referred to as a difficulty in initiating sleep, maintaining sleep or poor quality sleep in spite of have sufficient circumstances and opportunity for sleep (Walia et al, 2016). For a diagnosis of insomnia, the sleep disturbance should result in impairment in academic, social, job, behavioral or other essential functioning areas and cause substantial distress. In addition, insomnia diagnosis requires the patient to experience the sleep disturbance for a minimum of three nights weekly and for a minimum of three months. Insomnia normally causes daytime impairment in the mood, cognition,and performance that affects the patient, the family as well as their friends, colleagues,and caregivers. Evidence shows that patients with insomnia are likely to visit health facilities and physicians, have a high rate of absenteeism, have poor work performance, and experience more fatal traffic accidents (Walia et al, 2016). In addition, insomnia predisposes a person to an increased risk of depression, substance abuse, anxiety and self-medication (Arcangelo et al, 2017). Pharmacotherapy for Neurological Disorders Essay

Treatment options for Sleep Disorders (Insomnia)

Some of the treatment options for insomnia include benzodiazepines. Benzodiazepines function by acting as agonists by binding to the GABA and GABA_A receptors. They cause relaxation of muscles, sedation, and can reduce levels of anxiety. Benzodiazepines improve sleep time and quality of sleep by improving and decreasing sleep-onset latency and wakefulness following the sleep onset. In addition, they increase sleep efficiency (Asnis et al, 2015). Benzodiazepines have a high tolerance and can cause dependence when used for a long time and thus they are most suitable for treating for a short period. Use of benzodiazepines for above 4 weeks elevates the probability of dependence as well as withdrawal phenomena.  Examples of benzodiazepines commonly utilized in treating insomnia and are FDA-approved consist of triazolam (Halcion), quazepam (Doral, Questcor), estazolam, flurazepam,andtemazepam. The most prescribed benzodiazepine is temazepam and the choice of benzodiazepine is based on the duration of action and the target sleep onset (Lie et al, 2015). Pharmacotherapy for Neurological Disorders Essay

Zolpidem is a non-benzodiazepine used in the treatment of insomnia. The medication works by reducing sleep-onset latency and improving the quality of sleep. Zaleplon is also a non-benzodiazepine that is used to treat insomnia by reducing sleep-onset latency. Zaleplon is a short half-life (1 hour) and this means that the medication can be taken again after night-time awakenings (Asnis et al, 2015). Zaleplon is particularly used for individuals who experience problems in falling asleep and sleep maintenance. Evidence shows that Zaleplon has minimal psychomotor and memory impairments when compared to zolpidem and benzodiazepines (Asnis et al, 2015). Pharmacotherapy for Neurological Disorders Essay

Finally, ramelteon is also used in the treatment of insomnia and it is the only non-scheduled medication used in treating insomnia. Ramelteon targets the melatonin MT₁ and MT₂receptors within the brain and therefore increasing sleep duration and decreasing sleep-onset latency. There is a low probability of dependence and abuse for ramelteon and also the medication has minimal side effects (Lie et al, 2015).

ORDER A PLAGIARISM- FREE PAPER NOW

Age Factor

Age is an important factor to consider when prescribing medications for sleep disorders such as insomnia. This is because medications such as benzodiazepines and zolpidem have been shown to have serious adverse effects such as delirium, falls, cognitive impairment, and fractures as well. For this reason, medications such as benzodiazepines and zolpidem should be avoided for elderly patients. This is because such medications have been shown to cause serious side effects such as falls, dizziness,and weaknesses that may result in fractures (Brett &Murnion, 2015). In addition, the elderly population has elevated sensitivity and reduced metabolism for medications used to treat sleep disorders. Therefore, for the elderly experiencing insomnia, it is important to avoid prescription of benzodiazepine due to the associated side effects. However, if necessary, the medications can be administered in low doses and select medications with shorter durations (half-lives) to assist in minimizing the side effects (Brett &Murnion, 2015). Pharmacotherapy for Neurological Disorders Essay

In addition, care should be taken when administering medications such as benzodiazepines to young adults. This is because young adults aged between 18 to 25 years have a high tendency of misusing benzodiazepines due to their dependency aspect. Therefore, when prescribing medications to treat sleep disorders, it is important to educate the clients regarding their possible side effects and also educate them regarding the risk of benzodiazepines (Sidorchuk et al, 2018). Moreover, benzodiazepines should not be prescribed for more than 2-4 weeks in order to avoid dependency. Finally, prescription of benzodiazepines to treat insomnia for individuals aged below 18 years should be avoided (Sidorchuk et al, 2018). Pharmacotherapy for Neurological Disorders Essay

Care Plan for Patient XX (32-Year-Old Female)

Subjective

The patient reports that she is not able to sleep at night and she does not feel well rested. She verbalized that she goes to bed early enough but takes almost 3 hours for sleep onset and therefore has difficulties in initiating sleep. She also reported she sleeps for a short time and then wakes up till wee hours. She further reported that she was unable to concentrate and focus at the workplace. She also admits she dozes off at work and reports to be experiencing agitation easily. She also reported that lately, she takes alcohol to try sleep.

Objective

• She appeared fatigued and tired in the morning
• Dark circles under the eyes
• Lack of energy and seemingly worn-out. Pharmacotherapy for Neurological Disorders Essay

Assessment

Insomnia related to metabolic disease as exhibited by fatigue and lack of energy. Sleep disturbance as evidenced by self-report of difficulty in initiating and maintaining sleep, agitation, impairment in normal functioning, dozing at work and mood alteration (Wong & Ng, 2015).

Lorazepam an intermediate-acting benzodiazepine is prescribed for approximately two weeks to help improve her sleep pattern. The patient should take the medication when going to bed at night. The recommended lorazepam for the patient is 2-4 mg PO qHS (Jack et al, 2015).

Planning

After one week, the patient will be able to:

• Have an uninterrupted sleep pattern for 7-8 hours every night
• Report feeling more relaxed and rejuvenated after a night’s sleep
• Have a steady sleep routine

Evaluation

After one week of taking the prescribed medication, the patient will be able to sleep for 7-8 hours every night. After one week the patient will be able to easily initiate sleep during night time. She will verbalize feeling relaxed and rejuvenated after a night’s sleep and have a steady sleep pattern (Wong & Ng, 2015). Pharmacotherapy for Neurological Disorders Essay

References

American Psychiatric Association.(2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. Washington: American Psychiatric Association.

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Asnis G, Thomas M & Henderson M. (2015). Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians. Int J Mol Sci. 17(1), 50.

Brett  &Murnion B. (2015). Management of benzodiazepine misuse and dependence.AustPrescr. 38(5), 152–155.

Jack E, Daniel B, Germain A, Lewin D, Jason O & Timothy M. (2015). Quality Measures for the Care of Patients with Insomnia.J Clin Sleep Med. 11(3), 311–334.

Lie J, Tu K, Shen D & Wong B. (2015). Pharmacological Treatment of Insomnia.P T. 40(11), 759-768, 771.

Sidorchuk A, Isomura K, Molero Y, Hellner C, Lichtenstein P & Chang Z, et al. (2018). Benzodiazepine prescribing for children, adolescents, and young adults from 2006 through 2013: A total population register-linkage study. PLoS Med. 15(8): e1002635.

Wong S & Ng B. (2015). Review of sleep studies of patients with chronic insomnia at a sleep disorder unit. Singapore Med J. 56(6), 317–323.

Walia H &Mehra R. (2016).Overview of Common Sleep Disorders and Intersection with Dermatologic Conditions.Int J Mol Sci. 17(5), 654. Pharmacotherapy for Neurological Disorders Essay