Mental and Nervous System Disorders Paper Example

1. What are the common pharmacotherapeutic agents used to treat mental health disorders in the community setting? Include a discussion of side effects often seen in the primary care setting.

For mental health disorders, talk therapy (psychotherapies) and brain stimulation therapies are the most commonly opted for treatment depending on the condition at hand. Among the commonly used pharmacotherapeutic agents are antidepressants, anti-anxiety medication, stimulants, antipsychotics, and mood stabilizers. Antidepressants are those medications that are used to treat depression and its associated signs of anxiety, pain, and insomnia. Antidepressants form a larger group of drugs called Selective Serotonin Reuptake Inhibitors (SSRI) like citalopram, sertraline, paroxetine, escitalopram, and fluoxetine. Other forms of antidepressants comprise Serotine and Norepinephrine Reuptake Inhibitors (SNRI) such as venlafaxine and duloxetine. The third group are known as bupropion and works differently as compared to the first two. Based on the findings of the U.S. based Food and Drug Administration (FDA), these drugs have side effects such as nausea and vomiting, weight gain, diarrhea, sexual problems and sleepiness (Buttaro et al. 2017).

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Anti-anxiety medications are aimed at curbing the symptoms of extreme fear and worry, anxiety and panic attacks. The larger class of these medications is benzodiazepines, which comprises drugs such as clonazepam, alprazolam, and lorazepam. However, for long-term and chronic anxiety, buspirone is sometimes prescribed (Buttaro et al. 2017). Drowsiness, dizziness, nausea, blurred vision, confusion, headache, nightmares, and tiredness are some of the side effects of these drugs in the primary setting.

According to National Institute on Drug Abuse (2014), stimulants are medications that help increase the attention, energy, and alertness of the body as well as enhance blood pressure, heart rate, and respiration. They are described for given different age groups and include drugs like methylphenidate, amphetamine, and dextroamphetamine and lisdexamfetamine dimesylate among others. Stimulants induce side effects such as loss of appetite, stomach pains, headache, and sleeplessness. Antipsychotics are medicines used to manage psychosis, a mental condition that makes the victim lose touch with reality such as delusions and hallucinations. These medicines are usually used with others and are often categorized into generations. The first generation drugs include chlorpromazine, haloperidol, perphenazine, and fluphenazine while the newer or second-generation drugs include risperidone, quetiapine, lurasidone, and ziprasidone among others. They have the majority of side effects similar to the anti-anxiety medications but differ with restlessness, constipation, seizures and low blood pressure to highlight a few (Papadakis, McPhee & Rabow, 2018).

Finally, we have mood stabilizers which are used to treat bipolar disorders and the mood swings often due to other mental conditions. Among the mood stabilizers are lithium, carbamazepine, lamotrigine, and oxcarbazepine among others. Their side effects include blackouts, slurred speech, frequent urination, and loss of coordination to mention a few.

2. Evaluate two diagnostic tools used by an FNP for patients with complaints of dizziness and vertigo.

Dizziness can be classified into four main categories like vertigo, disequilibrium, presyncope, and lightheadedness based on their causes. The two diagnostic tools at the disposal of a Family Nurse Practitioner are as follows.

(a) Neuroimaging

The procedure involves scanning the brain to reveal the form and function of the brain. It helps to disclose the structure of the brain and the interconnection between the different parts, including the time events during various events like studying or memorizing (Papadakis, McPhee & Rabow, 2018). The process involves the use of sophisticated procedures of Computed Tomography (CT) Scans, functional MRI (fMRI), Diffusion Tensor Imaging (DTI), electroencephalography (EEG) and Positron Emission Tomography (PET) which are in themselves expensive. It is often argued that the method does not provide as many solutions to the diagnosis problem as it should be and that the use of the radiations exposes the patients to danger over time. However, with the advances in technology all around, the method can be relied on in the diagnosis of dizziness with much precision.

(b) Tympanometry testing (Middle ear test)

This procedure involves the application of pressure to the eardrum to make it move back and forth. The acoustic reflex then helps to determine the position of the problems like fluid retention or perforations by transmission of the sound to the middle ear. Notably, its effectiveness lies in distinguishing it from a stroke; the disorder could be a symptom of stroke (Papadakis, McPhee & Rabow, 2018). Misdiagnosis for stroke or exhaustion has always occurred leading to fatal prescriptions, under treatment, and a waste of resources for the hospital - consequently, life losses. This has necessitated the use of bedside diagnosis which gives good surety of the information to the FNP to make a well-informed decision.

3. Discuss the three main types of headaches and the primary treatment for each.

The three main types of headaches include migraine, tension headache, and cluster headaches. They are discussed below:

(a) Migraine

Primarily, the kind of headache causes occasional and incapacitating effects and lasts between a couple of hours and a few days. It is mostly witnessed in women during their premenstrual durations due to decrease, to the lowest levels, of the reproductive (hormones estrogen and progesterone) during the menstrual cycle (Department of Neurology, National Neuroscience Institute, NNI). The symptoms include pulsating pains, vomiting or nausea, cold and inactive limbs, visual symptoms, and pain that occurs only on one side of the head among others. The primary treatment includes the application of abortive therapy for the first time the symptoms which are observed and the diagnosis made by the family doctor. For acute migraines, triptans, ibuprofen, and intravenous metoclopramide (Reglan) should be prescribed, but taking care not to include medications including opiates and barbiturates (Buttaro et al. 2017). Equally notable, the drugs are not advisable for patients with vascular diseases, hypertension, and hemiplegic migraine. To prevent short tern migraines, however, dexamethasone is preferred.

(b)Tension Headaches

It is the primary headache that accounts for up to 90 percent of lifetime headache cases among adults, but most prevalent in women. Researchers believe that it is mostly instigated by physical and emotional stress that leads to contraction of the muscles which cover the skull, causing pain. The condition presents symptoms like sporadic pains around both sides of the head that present the most intense pressure over the eyebrows (Papadakis, McPhee & Rabow, 2018). For tension headaches, pain relievers including over-the-counter (OTC) such as aspirin, naproxen and ibuprofen can be used to reduce the initial pains (Buttaro et al. 2017). Also, triptans, narcotics, and a combination of drugs like acetaminophen and aspirin combined with caffeine can be ideal.

(c) Cluster Headache

It is the less incident kind of headache which mostly affects men in the age bracket of twenty years. The major signs are headache pains that wake the victim up from sleep at certain similar times of every night and the pains that occur on one particular side over the eye, resulting into redness of the same eye. Since the pains are usually short-lived, it is difficult to prescribe a treatment for cluster headache. If the condition proceeds to an acute stage, however, triptans, octreotide, local anesthetics, dihydroergotamine and inhaling air fully made up of oxygen can help relieve the situation.

References

Buttaro, T., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th Ed.). Mosby, Inc. ISBN-9780323355018

Buttaro, T., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2017).

Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2018). CURRENT medical diagnosis and treatment 2018 (57th ed.). Columbus, OH: McGraw-Hill Medical. ISBN-10: 1259861481 ISBN-13: 9781259861482