Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630

Sample Answer for Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630 Included After Question

Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630

According to the National Institute of Mental Health, around 9% of adolescents between the ages of 12 and 17 suffer from depression. Each year, around 7.9 percent of black youths are diagnosed with depression. According to a research, 3.2 percent of black teens expressed suicidal thoughts last year, and 1.4 percent attempted suicide (Ghandour et al., 2019). As future nurse practitioners, we must be culturally competent in order to address mental illnesses in a diverse patient population. In this assignment, I will examine the case of an African American youngster who is depressed, take into account the patient’s information, and make three therapy decisions for the patient. Additionally, I will consider the ethical implications of each decision and conclude with a summary of the patient’s treatment plan. Assessing and Treating Mood Disorders in Children and Adolescents 6630 NURS

According to the information presented, the patient is an African American child who is depressed. The patient exhibits a variety of symptoms, including sadness, withdrawal from classmates, decreased appetite, and irritability. According to the mental status evaluation, the patient frequently contemplates death and what it would be like to die. He, on the other hand, denies any suicidal thoughts or attempts, aural hallucination, or delusion. His physical examination is ordinary, as are his laboratory findings, which are within normal norms. He speaks clearly and has age-appropriate opinions. According to the clinician’s observations, the patients appear to be depressed, and he rarely smiles. Clinical guidelines and the DSM-5, together with the patient’s Children’s Depression Rating Scale score of 30, indicate that the primary diagnosis is depression (Ghandour et al., 2019). With the right treatment plan in place, the patient’s symptoms can be totally addressed, thereby improving his mental health and quality of life.

Decision #1 Top of Form

Selected Decision

Begin Zoloft 25mg orally daily.

Reason Behind Decision 1

Managing depression among children is quite challenging as a result of the lack of adequate data to support the efficacy of most antidepressants. However, most studies recommend the use of Zoloft (sertraline) among children with positive results. Sertraline is a selective serotonin reuptake inhibitor (SSRIs) that acts by inhibiting the central nervous system neuronal uptake of serotonin (5HT).

Among children, the recommended starting dose is 25mg. The drug has displayed a desirable safety profile and effectiveness in

managing depression among children above the age of 6 years, as reported by several studies (Pile, Shammas, & Smith, 2020). Zoloft also undergoes the first-pass metabolism with reduced side effects when well monitored. Other options such as daily 10 mg of Paxil, or even 75 mg of Wellbutrin twice daily could not be considered. Wellbutrin is not recommended for children below the age of 18 years as a result of inadequate information concerning its safety and effectiveness. Consequently, the drug is associated with adverse side effects such as anorexia and seizures. Paxil on the other hand is greatly discouraged for use among children as a result of reported cases of suicidal thoughts and attempts among those using the drug. This makes Zoloft 25mg the most favorable decision. Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630

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Expected Outcome

Within 4 weeks, the patient is expected to display greatly managed symptoms of depression. He should be able to feel less sad and interact appropriately with his peers in school. His appetite should be better, with fewer irritability symptoms (Ghandour et al., 2019). His Children’s Depression Rating Scale score is expected to reduce by 50%.

Ethical Considerations

Handling children with mental disorders poses great challenges. For instance, the guardian or parent has legal obligations of making health decisions for their children (Dawson, 2018). As such they must be informed of the available treatment option, and the effects of each decision made. In this case, the parent would support this decision.

Decision #2

Selected Decision

Increase Zoloft dose from 25mg to 50mg PO daily

Reason Behind Decision 2

After four weeks, the patient was brought back to the clinic with no changes in his depressive symptoms. As a result, increasing the dose of Zoloft to 50 mg is the most appropriate decision to make. The patient displayed no adverse effects, showing great tolerance to the medication. However, studies show that with inadequate response to the starting dose of Zoloft, it is necessary to titrate the dose in 25-50 mg per day increments once weeks to a maximum dose of 200mg (Dawson, 2018). This disqualifies the option of increasing the dose to 37.5 mg, as it is below the recommended dose, and will display almost the same results as using 25mg. Consequently, when discontinuing the use of Zoloft, it is recommended that the dose be reduced gradually first. As such it is not necessary to switch the medication with Prozac at this point. This will only lead to complications and new adverse effects such as further anorexia and increased anxiety.

Expected Outcome

After 4 weeks, the patient is expected to return to the clinic with greatly reduced symptoms of depression. He should be able to feel less sad and interact appropriately with his peers in school. His appetite should be better, with fewer irritability symptoms (Ghandour et al., 2019). His Children’s Depression Rating Scale score is expected to reduce from 30 to 15 or less.

Ethical Considerations

As per the results of the initial decision, the patient’s parent has the right of being informed on the reasons behind the outcome, and available alternative intervention for better results (Dawson, 2018). As per ethical requirements, nurses need to put the patient’s health at the center of care to promote health and wellbeing.

Decision #3

Selected Decision

Maintain Zoloft 50mg PO daily and continue to monitor progress

Reason Behind Decision 3

After 4 weeks, the patient reported back to the clinic with a 50% reduction in depressive symptoms. This indicates well tolerance and effectiveness of the medication, as no side effects were also reported at this point. Despite the current treatment goal of complete remission of symptoms by a drug, a 50% reduction of symptoms with no side effects within 8 weeks is quite impressive. Consequently, Zoloft is known to display its effects towards complete remission of symptoms within 8 to 12 weeks. As such, continuing the dose is necessary for further reduction of symptoms. Increasing the dose will lead to adverse effects as a result of increased plasma levels (Walkup, 2017). Consequently, changing the regimen to another drug will only lead to complications and new adverse effects.

Expected Outcome

Within four weeks, complete remission of the patient’s symptoms is expected. He should not feel sad at all and interact with peers freely at school. His appetite should be better with no signs of irritability. His scores on the Depression Rating Scale should reduce to less than 10 (Dawson, 2018). Generally, the patient’s symptoms should be completely managed by this time.

Ethical Considerations

The results display a positive outcome from the previous intervention which promotes the patient’s and family member’s trust in the healthcare provider. Trust is very crucial in promoting healthcare outcomes as it helps with patient commitment and adherence to the treatment plan (Dawson, 2018). As such, the patient parents will agree quite easily towards the next intervention made by the clinician.

Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630 Conclusion

Depression among minors has been growing over the past decade globally. As a result, most researchers are currently focusing on clinical trials on the safety and effectiveness of several medications for the management of this condition. With consideration of evidence-based practice in the current healthcare system, clinicians are required to choose the safest and effective medication, based on evidence when coming up with a treatment plan. In the provided case scenario of the African American child who is suffering from depression, the introduction of a starting dose of an SSRI, such as Zoloft was necessary, given the amount of evidence supporting the drug’s safety profile and effectiveness (Leichsenring et al., 2021). Despite the drug not showing any result within the first 4 weeks, it was necessary to increase the dose from 25mg to 50 mg, following the patient’s tolerance to the medication. At this point, the patient was able to exhibit a 50% reduction in symptoms, which would be considered an adequate trial of antidepressant effectiveness. As such, continuing the dose would be necessary for another 4 weeks for optimum results and complete remission of the symptoms. Consequently, ethical considerations were encountered when taking care of the patient. For instance, the patient’s mother was involved in making all the treatment decisions given that the patient is a minor. She was informed of the treatment options available and both their positive and negative outcome before any decision was made.

Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630 References

Dawson, R. S. (July 01, 2018). Depression in children and adolescents: The pediatrician at the front lines. Pediatric Annals, 47, 7.) https://doi.org/10.3928/19382359-20180618-01

Top of Form

Leichsenring, F., Luyten, P., Abbass, A., Rabung, S., & Steinert, C. (January 01, 2021). Treatment of depression in children and adolescents. The Lancet. Psychiatry, 8, 2, 96-97. DOI: https://doi.org/10.1016/S2215-0366(20)30492-2

Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (January 01, 2019). Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children. The Journal of Pediatrics, 206, 256-267. https://doi.org/10.1016/j.jpeds.2018.09.021Top of Form

Pile, V., Shammas, D., & Smith, P. (January 01, 2020). Assessment and treatment of depression in children and young people in the United Kingdom: Comparison of access to services and provision at two-time points. Clinical Child Psychology and Psychiatry, 25, 1, 119-132. https://doi.org/10.1177/1359104519858112

Walkup, J. T. (May 01, 2017). Antidepressant efficacy for depression in children and adolescents: Industry- and NIMH-funded studies. American Journal of Psychiatry, 174, 5, 430-437. https://doi.org/10.1176/appi.ajp.2017.16091059

A Sample Answer For the Assignment: Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630

Title: Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630

According to theNational Institute of Mental Health,approximately 9% of teenagers from the age of 12 to 17 years have depression disorder in the United States.Ghandour et al., (2019) reported that about 3.2% of African American adolescents presented with suicidal thoughtsin 2018as 1.4%tried to commit. Despite the burden associated with this mental disorder, several treatment options are available to help manage the symptoms and promote the quality of life of children and adolescents with this disorder.

The assigned case study demonstrates an African American boy child diagnosed with depression. The patient reports symptoms such as irritability, feeling sad, decreased appetite, and withdrawalfrom social gatherings like school. The conducted mental status examination revealed that the patient is suicidal, but has never tried to kill himself. The patient however denies hallucinations and delirium among other psychotic symptoms. Based on clinical practice guidelines and DSM-5 diagnostic criteria,together with a score of 30 on theChildren’s Depression Rating Scale,the patient’s primary diagnosis is depression.

The patient’s age, African American race, and anxiety diagnosis are some of the factors which might affect the choice of drugs for the management of the patient’s symptoms. For instance, most antipsychotic agents are associated with suicidal attempts, among other side effects hence must be monitored closely when use among children and adolescents. Additionally, a study conducted by (Leichsenring et al., 2021) reported that African Americans are more likely tocarry alleles that slow down the metabolism of most antidepressants such as tricyclic antidepressants (TCA), leading to a ‘slowmetabolizer’ phenotype hence higher blood TCA plasma level, in addition to more rapid response. The purpose of this paper is to demonstrate the decision-making process of the most effective medication to include in the patient’s treatment plan, while observing pharmacokinetic and pharmacodynamic factors, in addition to ethical considerations which might impact this care process.

Decision #1 Top of Form

Selected Decision and Rationale

The initial intervention is to start the patient on Zoloft 25 mg orally once daily. Sertraline belongs to the class of selective serotonin reuptake inhibitors (SSRIs), recommended in national clinical guidelines as the first-line for the management of depression in children and adults (Walkup, 2017).

Considering the patient’s specific factors, Zoloft is the best choice of drug for the management of depressive symptoms displayed by the patient. anxiety symptoms. For instance,most studies recommend the use of sertraline among children as a result of its great effectiveness and desirable safety profile reported by the few conducted clinical trials. The drug acts by inhibiting the central nervous system (CNS) neuronal uptake of serotonin(5HT) (Pile et al., 2020). Among children, the recommended starting dose is 25mg. The drug is absorbed slowly in the GIT with a peak plasma level being attained after 6 to 8 hours, necessary to elicit optimal therapeutic action. Studies have also identified several polymorphisms in genes encoding P-450 isoenzymes (2D6 and 2C19) among African Americans which affect the metabolism of the drug. However, when used in low disease, the drugs have displayed great effectiveness with an appealing safety profile.

Wellbutrin on the other hand is not recommended for children less than 18 years due to evidence deficits in its safety and effectiveness (Ghandour et al., 2019). The drug is also associated with high suicidal incidence, hence not appropriate for this patient as he already displayed symptoms of suicidal ideation. Paxil is also not appropriate for this patient as it is also associated with high suicide incidences as the FDA issued a black box warning for use of the drug among this vulnerable population (Leichsenring et al., 2021). It should only be considered in case there is no other suitable option which in this case is Zoloft as described above.

Expected Outcome

The drug is expected to display at least 50% remission of the patient’s depression symptoms within the next 4 to 8 weeks. As a result, theChildren’s Depression Rating Scalescores are expected to decrease to less than 10 from 30. Only common self-limiting side effects such as dry mouth increased sweating and headache might be expected(Walkup, 2017).

Ethical Considerations

Given that the patient is under the age of 18 years, it will be necessary for the PMHNP to adequately inform the patient’s parents about the available treatment options and their benefits and risks to involve them in decision making concerning the health of their child(Pile et al., 2020). Parents and guardians have legal authority in making healthcare decisions for their children.

Decision #2

Selected Decision and Rationale

The second decision is to increase the Zoloft dose from 25mg to 50mg PO daily. Studies show that the dose of Zoloft should be increased at intervals of 25mg to 50 mg per day once weekly when the desired therapeutic response has not been attained among children, while closely monitoring the patient’s symptoms(Ghandour et al., 2019).

This decision was based on the treatment outcome as the patient reported no changes in his depressive symptoms after four weeks of therapy. Increasing the dose of Zoloft to 50 mg is the best decision at this point, and evaluate the patient outcome after another 4 weeks. Studies show t that it takes between 8 to 12 weeks for sertraline to attain optimum therapeutic action in completely managing depression symptoms(Leichsenring et al., 2021). However, the dose must be increased gradually, while monitoring patient symptoms to attain an optimum dose. The patient also displayed no adverse effects, indicating great tolerance to the medication, hence no reason to alter the medication.

Increasing the dose to 37.5mg is not appropriate as this would only display similar results, as that titration rate is not recommended in several clinical guidelines(Walkup, 2017). Consequently, this will only prolong the period of use of the drug to the point where optimum dose will be attained. Discontinuing the use of sertraline, is also not necessary at this point, as studies only recommend it in case the maximum dose has been reached with no effect or the patient displays adverse effects(Pile et al., 2020). Consequently, studies recommend that the dose be reduced gradually first before switching to another drug like Prozac which is associated with several adverse effects as described above.

Expected Outcome

With the dose increment of Zoloft to 50mg, the patient is expected to display atleast 50% remission of symptoms this time round unlike within the first 4 weeks(Ghandour et al., 2019). His score on the Children’s Depression Rating Scalescores is also expected to decrease to less than 10. No side effects are expected since the patient already displayed great tolerance to the drug.

Ethical Considerations

The PMHNP has a legal obligation of preventing harm and promoting the health of the patient (Dawson, 2018). As such, considering a dose increment of the drug was the best choice in managing the patient’s symptoms, with limited side effects (Walkup, 2017). This decision promotes ethical principles such as beneficence and non-maleficence.

Decision #3

Selected Decision and Rationale

The last decision is to maintain the dose of Zoloft at 50mg once daily and continue evaluating the progress of the patient. The evidence-based practice recommends dose maintenance once the optimum level has been maintained until the patient’s symptoms have been resolved completely (Pile et al., 2020).

This decision was supported by the outcome the patient displayed in the last four weeks with a 50% reduction in depressive symptoms. The outcome shows great effectiveness and adherence to the medication by the patient, hence the need to maintain the dose. Studies show that it may take the drug another 4 to 8 weeks for Zoloft to completely manage symptoms of depression once the optimum dose has been achieved (Leichsenring et al., 2021). Additionally, this dose is still low hence limiting the possibility of side effects or toxicity.

Increasing the dose of Zoloft is not necessary as this will only lead to increased risks of adverse effects and toxicity due to increased plasma levels(Dawson, 2018). Additionally, the patient’s age does not allow a higher dose of the drug, as this could lead to increased suicidal ideation. Changing the treatment regimen to another drug, is also not appropriate as this will only lead to new complications (Walkup, 2017). This will also affect the patient compliance with the treatment regimen.

Expected Outcome

The patient is expected to display completely managed depression symptoms within the next four weeks. His score on the Children’s Depression Rating Scalescores is also expected to decrease to less than 10(Dawson, 2018). The patient’s quality of life will improve within this time, with no side effects reported as a result of the displayed tolerance and adherence to the treatment.

Ethical Considerations

At this point, the PMHNP is required to consider the ethical principle of nonmaleficence. Out of all the available options, maintaining the dose is the only choice that will benefit the patient with no harm (Pile et al., 2020). The patient’s parents must however be informed of the red flags like suicidal ideation and the importance of sticking to the treatment regimen to enhance optimal care outcomes.

Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630 Conclusion

Depression is a common mental problem among children below the age of 17 years. It affects both their social and academic life with additional mental and physical health burdens. Researchers have however been able to confirm the effectiveness of several treatment options for the management of depression among this vulnerable population (Ghandour et al., 2019). For the African American child with depression, factors such as his race and age were considered in choosing the best drug in the management of his symptoms. The first choice was Zoloft 25 mg once daily, which is an SSRI recommended by most clinical guidelines as a first-line for the management of depression among children due to its great effectiveness reported in most studies (Pile et al., 2020). Other alternatives such as Paxil and Wellbutrin were not appropriate due to their increased risk of suicide.

The second decision was to increase the dose to 50mg given the lack of effectiveness within the first 4 weeks. Increasing the dose to 37.5mg or replacing the drug with Prozac is not necessary as the former will lead to a similar outcome as the latter will compromise the patient’s tolerance (Walkup, 2017). The last decision was to maintain the dose at 50mg and monitor patient outcome for the next 4 weeks. The patient displayed great effectiveness and tolerance of the second intervention hence the need to maintain the dose. Increasing the dose to 75 or replacing the drug was not necessary as a result of the increased risk of toxicity and adverse events (Leichsenring et al., 2021). On the other hand, the PMHNP had to observe several legal and ethical considerations given that the patient is a minor such as the right to information, beneficence, and non-maleficence (Dawson, 2018).

Assignment Assessing and Treating Pediatric Patients With Mood Disorders NURS 6630 References

Top of Form

Dawson, R. S. (July 01, 2018). Depression in children and adolescents: The pediatrician at the front lines. Pediatric Annals, 47, 7.)https://doi.org/10.3928/19382359-20180618-01

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.

Most drugs act by being agonists or antagonists at receptors that respond to chemical messages such as neurotransmitters. An agonist is a drug that binds to the receptor and produces an effect similar to the intended chemical and receptor (Stahl, 2021). Opioid drugs for example heroin and methadone are agonists that produce responses such as analgesia and respiratory depression. Whereas an antagonist is a drug that binds to the same receptor but does not produce a response instead it blocks or slows that receptor from producing a response to a natural agonist (Stahl, 2021). Antagonism may be competitive and can be reversed by a high concentration of agonists (Stahl, 2021). Naltrexone is an antagonist drug, therefore if heroin or methadone is present and activates the receptor, taking naltrexone will counteract the activation, resulting in withdrawal (Stahl, 2021). A partial agonist binds and activates the receptor and produces an effect within a cell that is partially efficacy by blocking the receptors to the full agonist (Stahl, 2021). In addition, it weakly activates the receptor, thus producing a submaximal biological response for example the drug buprenorphine (Stahl, 2021). Buprenorphine allows partial binding to opioid receptors, thus reducing withdrawal symptoms and curving drug cravings. An inverse agonist binds to the same receptor site as an agonist and produces a biological response opposite to that of the agonist (Stahl, 2021). The drug Flumazenil is an inverse agonist because it produces an anxiogenic effect on the GABA receptor (Stahl, 2021).

Compare and contrast the actions of g couple proteins and ion-gated channels.

G-couple protein receptors are also called G-protein-couple receptors (GPCRs) and are only found in eukaryotes, and they comprise the largest known class of plasma membrane receptors (Stahl, 2021). There are two classes of G-proteins, the first function as monomeric small GTPases (small G-proteins), while the second function as heterotrimeric G protein complexes (Stahl, 2021). There are two major classes of ion channels. One class of ion channel is opened by neurotransmitters and are called ligand-gated ion channels (IGCs), ionotropic receptors, and ion-channel-linked receptors, and the other major class is opened by charge or voltage across the membrane and is also called voltage-gated or voltage-sensitive ion channel and are found in the plasma membrane (Stahl, 2021). GPCRs interact with a variety of proteins for an intracellular response, while ion channels regulate the flow of ions (Khan Academy, n.d.). Both G protein-coupled receptors and ligand-gated ion channels are cell surface receptors (Stahl, 2021). G proteins in general are specialized proteins that can bind guanosine triphosphate (GTP) and guanosine diphosphate (GDP) (Stahl, 2021). GPCR consists of a single polypeptide that is threaded over the membrane, while ion channels are composed of pores that open and close upon ligand binding (Khan Academy, n.d.). The family of heterotrimeric guanine nucleotide-binding regulatory proteins (G proteins) serves an essential role in transducing receptors and generating signals across the plasma membrane (Khan Academy, n.d.). Ion channel receptors are a vital component of nervous system signaling, allowing rapid and direct conversion of a chemical neurotransmitter message to an electrical current (Khan Academy, n.d.). GPRS is heterotrimeric meaning that they have three different subunits, the first subunit or section of this protein we call the alpha subunit the second we call beta and the third we call gamma (Stahl, 2021). All three alpha, beta, and gamma subunits make up the G protein (Stahl, 2021). Alpha and gamma are attached to the cell membrane by lipid anchors, while IGCs do not. GTP-binding alpha-subunits and the beta gamma-subunit complex can influence the activity of effector molecules independently or simultaneously, either synergistically or in opposition, to elicit a complex constellation of cellular events (Stahl, 2021). The most important characteristic of GPCRs is that they have seven transmembrane alpha helices while IGCs do not have this structure (Stahl, 2021). Both GPCR and IGC undergo conformational change (Stahl, 2021). When the ligand binds to GPCR undergoes a conformational change and it changes the structure and exchanges the GDP for GTP bound to the alpha subunit (Stahl, 2021). In addition, the alpha subunit dissociates and moves away from the beta and gamma subunit and are turned on (Stahl, 2021). When it is attached to GDP it is turned off, beta gamma subunits can still regulate the functions of other proteins the target proteins can be enzymes that produce second messengers (Stahl, 2021). G-protein regulates metabolic enzymes, ion channels, and transporter proteins whereas ion channels regulate calcium, sodium, chloride, and potassium (Stahl, 2021).

Explain how the role of epigenetics may contribute to pharmacologic action.

Epigenetics is the study of how one’s behaviors and environmental factors can cause changes that affect the way genes function (Centers for Disease Control and Prevention (CDC), 2022). Unlike genetic changes, epigenetic changes are reversible and do not change your DNA sequence, however, it can affect how one’s body reads a DNA sequence (CDC, 2022). Epigenetic changes affect gene expression to turn genes “on” and “off”. Epigenetics is being used to help identify DNA modifications that are implicated in diseases, therefore, suggesting new potential therapeutic targets be explored in drug development. As a result, epigenetics can determine how a medication works and what illnesses an individual may develop. If a medication works on a specific gene, but that gene has an altered function, the drug’s efficacy may change. Epigenetics can be used to help determine which type of cancer a person has or can help to find hard-to-detect cancers earlier (Bayoumi et al., 2020). Furthermore, the human epigenome provides important evidence in understanding the basis of gene-environment interactions, because it exhibits high plasticity in adaptation to environmental cues, such as diet, toxins, and stress, over the life span to modulate gene expression and functional states of the body (Bayoumi et al., 2020). New classes of drugs are currently used to regulate epigenetic mechanisms to manage diseases in individuals (Bayoumi et al., 2020).

Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

As a psychiatric nurse practitioner and prescriber, I must understand the biological and physical aspects of prescribing medication to the mental health population. This information is essential for providers because it will help in the development and understanding of both the short-term and long-term effectiveness of medication (Glue et al., 2020). Within psychiatry, medications are considered a cornerstone of treatment. However, Starting the right medicines as soon as possible can improve certain situations and improve the patient’s quality of life, but the inappropriate drug may result in negative effects and damage. Knowing the basic concept and knowledge of how the agonist, antagonist, partial, and inverse agonist functionality; having a clear picture of the actions of g couple proteins and ion gated channels; understanding the role of epigenetics and how it contributes to pharmacologic action are all essential information when prescribing drugs. With this information psychiatric nurse practitioners will be better able to practice safe and effective medication administration. An example would be the use of benzodiazepine. The intended purpose of benzodiazepine is to reduce anxiety, but daily extended treatment may lead to rapid tolerance onset (Glue et al., 2020). In time the patient will form a tolerance to the highest dose of benzodiazepine, leading to experiencing side effects from consuming such a large dose. Over time, the patient might develop a tolerance to the optimal dose of benzodiazepines, resulting in an overdose due to the tolerance effect (Glue et al., 2020). In addition, patients may need to stop taking the medication, which will contribute to debilitating protracted withdrawal symptoms. Some of the most extreme dangers associated with psychiatric drugs include drug-induced psychosis, tardive dyskinesia, brain volume loss, and dementia and possibly an early onset of dementia several years in the future (Mental Health Daily, 2023). Therefore, it may be necessary for the patient to limit the taking of drugs that may lead to memory and cognitive impairment and lead to early dementia with prolonged overuse (Mental Health Daily, 2023). As a prescriber, it is very important to know the drug’s effectiveness, adverse effect, and contraindications and more importantly to educate patients on the intended use of the drug, expected outcomes, and potential side effects.