COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521

Summary of Patient Case Study

A 71-year-old Asian man with a history of GAD, which was caused by diabetes and hypertension, was presented to our inpatient psychiatric clinic. He was mainly brought for stabilization and long-term medication. The information gathered from the family stated that the patient had refused oral food intake for about thirty hours, was isolative in his room, and had increased confusion. The diagnosis also showed a history of GAD in the patient’s family, especially among aged people. After admitting him to our clinic, the clinical presentation of the patient depicted a transformed level of consciousness. I took three imperative decisions I thought could help him. They include: stabilizing him, performing psychotherapy, and administering relevant medication.

                                                                                     Evaluation of My Decisions

I believe the decisions I provided were supported by evidence-based literature. According to Watts et al. (2020), psychotherapy involves working with therapists to reduce the level of GAD. For example, in our case, I recommended the therapist to use behavioral therapy because it was the most effective psychotherapy for GAD. On the other hand, stabilizing the patient is imperative because it ensures the conditions of the patient are within the healthy range (Savioli et al., 2020). For example, in our case, I recommended calming the patient to regain his level of consciousness.  Lastly, I recommended the patient’s medication because it could ease symptoms and prevent or halt hypertension and diabetic conditions (Wilhelmsen & Eriksson, 2019). Medication was the heart of everything because the patient’s issues were beyond anxiety disorders.

                                                                                  Objectives of My Decisions

First, I hoped behavioral therapy could help the patient manage various GAD-related symptoms, such as anxiety and stress. I also expected this treatment option could help the patient cope with negative emotions. Second, I hoped the medication decisions I recommended, such as Crestor 20mg daily, Lantus insulin 10 units daily, Metformin 70mg daily, Lithium 300mg daily, and hydrochlorothiazide 25mg daily, could help the patient improve his hypertension and diabetic conditions. Lastly, I hoped the patient would be stable after recommending a stabilization program in the emergency room. I also expected his pressure to normalize after calming him by providing personal attention.

                                                                         Differences between Expectations and Results

In psychotherapy, the expected results were attained. For example, the patient coped with adverse emotions and managed his anxiety and stress. He calmed down and started conversing with me. On the other hand, the prescribed medication also responded positively as planned. For example, in this decision, I aimed to improve the patient’s diabetic condition, which came down to manageable levels. Therefore, there was no difference between the anticipated and results. Lastly, the objectives of my decision to stabilize the patient aligned with the outcomes. For example, the patient’s hypertension was very high, but I managed to bring it to normal levels.

                                                                     Pharmacokinetics and Pharmacodynamics Processes

In the pharmacokinetics process, the medication I recommended, especially oral medication, undergoes three stages. Absorption is the first stage, where the medicine is ingested and passed through the stomach into the intestine linings. The second stage is distribution, where the drugs pass through the liver and intestines into the bloodstream. The third stage is metabolism, where the drug undergoes glucuronidation and oxidation. The last stage is the excretion of the medicine, mainly through the functioning of the kidney. The pharmacodynamics commences when the drug reaches the target organ or tissue. The drug may involve enzyme inhibition or cause presynaptic or postsynaptic effects on the patient. The final part of pharmacodynamics involves cellular response and signal transduction.

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521
COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521

 

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521

Generalized anxiety disorder affects millions of people worldwide.  There are numerous
options for pharmacologic management of this prevalent and debilitating disorder.  This post will
provide a case study and considerations for pharmacologic management of the study subject.

“SC is a 39-year-old female who is experiencing chest pain, back pain, heart palpitations
and reports shortness of breath stating, “It feels like the air is thick.”  She also reports trouble
sleeping due to “over thinking things” but she does not consider this to be worrying.   These
symptoms occur approximately four times each week and are most prevalent in the morning
when SC is on her way to work.  Current medications include metformin ER 500mg daily,
zolpidem 6.25mg daily at bedtime, estradiol transdermal patch 0.075mg twice weekly.  SC
reports she has experience episodes of depression and anxiety since age 17 but has not ever seen
a doctor for these problems.  Her health history includes polycystic ovary syndrome, total
hysterectomy, sleep disorder, and Type II diabetes.  Her BMI is 32.9 which indicates obesity.
She is the single mother of a child who has a diagnosis of autism, and she is building a new
home.  Social support includes friends at work and her mother who lives in her home.
A 12-lead ECG shows normal sinus rhythm with no ectopy noted.  SC is diagnosed with
generalized anxiety disorder.  Bupropion XL 300mg daily and buspirone 5mg daily are
prescribed.  Bupropion XL is an atypical antidepressant that is a weak reuptake inhibitor of
norepinephrine and dopamine.  The drug is extensively metabolized with CYP2B6 as the
principal isoenzyme involved in metabolism and is excreted in urine and feces.   Bupropion XL
peaks in plasma seven hours after dosing.  The half-life of the drug is 21 to 30 hours with steady-
state plasma concentrations achieved in eight days (Food and Drug Administration [FDA],
2009).   Drug-drug interactions are common when Bupropion XL is administered with other
medications that are metabolized by CYP2D6 isoenzyme.
Buspirone HCL is an antianxiety drug that is not a benzodiazepine.  It does not cause
sedation or muscle relaxation which are common side effects of benzodiazepine drugs.

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Buspirone has a high affinity for serotonin receptors and dopamine receptors in the brain.  It does
not affect GABA binding (Speed Pharmacology, 2018).
Buspirone is rapidly absorbed following oral administration and undergoes extensive
first-pass metabolism.  Peak plasma levels of the drug occur in 40 to 90 minutes (Food and Drug
Administration [FDA], 2010).  Buspirone is shown to be mediated by CYP3A4 isoenzyme and is
safe when taken with bupropion XL.
SC returned was advised to report worsening symptoms of depression or anxiety to the
physician and was scheduled for follow up in two weeks.  On return she reported feeling much
better with no chest pain, heart palpitations, or shortness of breath for the last five days.  She also
reports she is not over thinking things as much as she was prior to treatment.  No changes were
made to her medication regimen and additional follow up was scheduled in four weeks.
When deciding how to treat generalized anxiety disorder (GAD) healthcare providers
must be careful not to confuse situational anxiety with GAD.  Benzodiazepines are
recommended for acute anxiety and panic attacks.  These drugs carry a risk of physical
dependence.  Long-term use can cause withdrawal symptoms to occur, and these medications
must be tapered over a period of weeks to months (Rosenthal & Burchum, 2021, p. 244).  Other
drugs used for the treatment of GAD include Serotonergic reuptake inhibitors (SRIs), tricyclic
antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors, and monoamine oxidase
inhibitors (MAOIs).  Of these, all have side effects however MAOIs have a high incident of
drug-drug reactions and risk of hypertensive crisis and stroke if the patient eats foods high in
tyramine (cheese, cured meats, sauces and alcohol) (Speed Pharmacology, 2018).

GAD is a common psychiatric illness that one in every four people will experience in
their lifetime.  Determining the best pharmacologic treatment and combining it with
psychotherapy is needed to provide optimal patient outcomes.

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521 References

Food and Drug Administration. (2009). Wellbutrin XL. fda access data. Retrieved April 22, 2022,
from https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021515s023s024lbl.pdf
Food and Drug Administration. (2010). buspirone HCL, USP. FDA access data. Retrieved April
22, 2022, from
https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/018731s051lbl.pdf
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne's pharmacotherapeutics for advanced practice
nurses and physician assistants (2nd ed.). Elsevier.
Speed Pharmacology. (2018). Pharmacology – Benzodiazepines, barbiturates, hypnotics (Made
Easy) [Video]. You Tube. https://www.youtube.com/watch?v=4ZHudeMho8g&t=24s

RE: Week 8 Main Post

Hi Tracey! I enjoyed reading your post! You are correct with your statement that
healthcare providers should not be confuse with situational anxiety versus GAD in

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521
COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521

giving treatment. Situational anxiety can be normal and is common. Like for example:
feeling anxious with job interview, first day of school or giving presentation to a class or
large group. The pharmacologic treatment are the following: Xanax (Alprazolam),
Klonopin (Clonazepam), Ativan (Lorazepam)-to manage anxiety attack. Psychotherapy
is recommended such as: Cognitive- Behavioral therapy or exposure therapy (Cherry,
K.2020).

I have resident here in Assisted living- a 93 year old Caucasian female who were
admitted in the facility with a Diagnosis of Anxiety Disorder, Unspecified. She is
coherent, conversant and independent of her ADLs. This resident has no other health
issues but when anxiety attack especially in the afternoon she would walk and find a
way to release her anxiety until she had an incident of fall which she had hip and arm
fracture. She was treated in the hospital and after 3 days she went back to the facility.
She was prescribed LORazepam Tablet 0.5 MG  to Give 1 tablet by mouth two times a
day for anxiety for 6 Months. After 6 months her behavior was reviewed and it shows that it was
effective for her and she was maintained on Lorazepam until now. Lorazepam belongs to a class of
drugs- Benzodiazepines, which act to the brain and nerves to give a calming effect that ease the
symptoms of anxiety. Lorazepam works by enhancing the effects of a certain natural chemical in the
body (GABA).It is not a narcotic but may produce narcotic effects (Cunha, 2021).

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521 References

Cherry, Kendra, 2020. What is Situational Anxiety? https://www.verywellmind.com/what-is-
situational-anxiety-

Cunha, John P.,2021 Lorazepam. https://www.rxlist.com/consumer_lorazepam_ativan/drugs-
condition.htm

RE: Week 8 Main Post

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Hello Margie,
Thank you for your response.  It sounds like the female resident you speak of was well cared for
during this trial.  I hope she is back to walking.  You mention that lorazepam was used to treat
her anxiety or late afternoon panic attacks until now.  How long will it take to wean this patient
off the lorazepam?  Hopefully she is also receiving behavioral therapy to help.  Withdrawal
symptoms from benzodiazepines include panic, paranoia, and delirium.  These medications
require tapering off over a period of several months (Rosenthal & Burchum, 2021, p. 244).
Thank you again for your response!

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521 References

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

Week 8 Discussion Main Post

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The importance of mental health pharmacology therapy continues to increase.  The purpose of
this discussion is to share pharmacodynamics, pharmacokinetics, and treatment options of

generalized anxiety disorder (GAD).  In depth drug therapy comprehension of GAD improves
the quality of mental health pharmacology, parallel to importance.

Pharmacodynamics

Pharmacodynamics of SSRIs, as a anxiolytic drug therapy is the focused comprehension
for pharmacodynamics.  Selective serotonin reuptake inhibitors (SSRIs) is the focus due to its
primary mechanism of action to inhibit presynaptic reuptake of serotonin at the serotonin
transporter (Edinoff, Akuly, Hanna, Ochoa, Patti, Ghaffar, … & Kaye,  2021).  As a nurse
practitioner understands the mode of action for SSRIs, safety and efficacy of the drug therapy
improves.   Factors that may affect SSRIs mechanism include genetics (Pogliani, Falvella,
Cattaneo, Pileri, Moscatiello, Cheli, … & Zuccotti, 2017).  Therefore practitioners would
consider genetics in their patients assessment and examinations.

Pharmacokinetics

Pharmacokinetics of anxiolytic drugs are extremely important to know and appropriately
take into consideration for a patient’s pharmacotherapy.  Selective serotonin reuptake inhibitors
(SSRIs) have favorable pharmacokinetics compared to drugs, such as, benzodiazepines (Crocco,
Jaramillo, Cruz-Ortiz, & Camfield, 2017).  Therefore, I chose to explore pharmacokinetics of
SSRIs.  SSRIs metabolic enzyme, cytochromes create large volumes of distribution (Pogliani,
Falvella, Cattaneo, Pileri, Moscatiello, Cheli, … & Zuccotti, 2017).  The practitioners
comprehend that the creation of large volume allows SSRIs to cover more areas, which increases
the safety of the drug. Other factors to consider with SSRIs pharmacokinetics is age, liver
function, kidney function (Strawn, Geracioti, Rajdev, Clemenza, & Levine, 2018).  If the

practitioner understands that SSRIs metabolize in liver and their patient has liver failure, the drug
would unsafe.

Treatment Options

Exploring treatment options for GAD is vital to patients’ mental healthcare quality.
Concurrent psychotherapy and pharmacotherapy is a recommendation with first line drug
therapy of selective serotonin reuptake inhibitors (SSRIs) are the first-line drug therapy due to its
broad-spectrum efficacy and second-line pharmacotherapies may include buspirone,
benzodiazepins, SGAs and pregabalin (Strawn, Geracioti, Rajdev, Clemenza, & Levine, 2018).
A patient with GAD should seek mental health therapy simultaneous as they start drug therapy;
the combination of both therapies has a better chance of improving symptoms.  Other treatment
options are available if the first line therapy is ineffective.

Summary

Data about pharmacotherapy for mental health continues to trend with much importance.
Discussions about the pharmacodynamics, pharmacokinetics, and treatment options allows nurse
practitioner students to increase their knowledge on anxiolytic pharmacotherapy.  As the student
nurses continues to enhance their knowledge base, mental health pharmacotherapy advances.

 

 

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521 References

Crocco, E. A., Jaramillo, S., Cruz-Ortiz, C., & Camfield, K. (2017). Pharmacological management of
anxiety disorders in the elderly. Current treatment options in psychiatry, 4(1), 33-46.

Edinoff, A. N., Akuly, H. A., Hanna, T. A., Ochoa, C. O., Patti, S. J., Ghaffar, Y. A., … & Kaye, A. M.
(2021). Selective serotonin reuptake inhibitors and adverse effects: a narrative review. Neurology
International, 13(3), 387-401.

Pogliani, L., Falvella, F. S., Cattaneo, D., Pileri, P., Moscatiello, A. F., Cheli, S., … & Zuccotti, G.
(2017). Pharmacokinetics and pharmacogenetics of selective serotonin reuptake inhibitors during
pregnancy: an observational study. Therapeutic Drug Monitoring, 39(2), 197-201.

Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for
generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment
review. Expert opinion on pharmacotherapy, 19(10), 1057-1070.

Pharmacological Options for Generalized Anxiety Disorders

Generalized anxiety disorder is a chronic illness characterized by pervasive, widespread anxiety affecting several domains. It usually begins in adolescence or early adulthood and persists throughout life (Strawn et al., 2018). In terms of management, both psychotherapy and pharmacotherapy methods should be used together for maximum outcomes. Drugs used for the management of GAD include antidepressants like Selective serotonin reuptake inhibitors (SSRIs), Selective serotonin-norepinephrine reuptake inhibitors (SSNRIs), benzodiazepines, monoamine oxidase inhibitors (MAOi), tricyclics antidepressants (TCAs), and second-generation antipsychotics (Melaragno, 2021). The first line is either an SSRI or SNRI. The purpose of this paper is to compare various GAD pharmacotherapies.

Comparison

Most of the agents used in the management of GAD function by increasing serotonin concentration except for benzodiazepines (Stein, 2021). SSRIs inhibit serotonin reuptake hence increasing the synaptic concentration, SSNRIs inhibit the reuptake of both norepinephrine and serotonin, second-generation agents like olanzapine and risperidone inhibit both dopamine and serotonin receptors thus increasing their concentrations, MAOi inhibit the enzyme monoamine oxidase which deactivates dopamine, serotonin, and norepinephrine thus increasing their concentrations, and TCAs block norepinephrine transporter and are potent inhibitors of serotonin reuptake (Garakani et al., 2020). Benzodiazepines bind GABA A receptors and act as allosteric modulators hence potentiating the effects of endogenic GABA. In both long and short terms of treatment, SSRIs have a broad spectrum in terms of efficacy, TCAs have a slow onset of anxiolytic action and a wide range of adverse effects on the other hand benzodiazepines have been discouraged because of the risk of drug dependence.

Conclusion

In adults, either SSRIs or SNRIs can be the first-line agents while in the pediatric age group, the first-line drug is an SSRI. Newer agents with better pharmacologic profiles are being discovered, the latest of which is agomelatine which is both a melatonin receptor agonist and a serotonin receptor antagonist. It has efficacy and tolerability profiles that compare favorably with escitalopram.

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521 References

Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: Current and emerging treatment options. Frontiers in Psychiatry11, 595584. https://doi.org/10.3389/fpsyt.2020.595584

Melaragno, A. J. (2021). Pharmacotherapy for anxiety disorders: From first-line options to treatment resistance. Focus (American Psychiatric Publishing)19(2), 145–160. https://doi.org/10.1176/appi.focus.20200048

Stein, D. J. (2021). Evidence-based pharmacotherapy of generalised anxiety disorder: Focus on agomelatine. Advances in Therapy38(Suppl 2), 52–60. https://doi.org/10.1007/s12325-021-01860-1

Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert Opinion on Pharmacotherapy19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966

Pharmacologic Options for the Treatment of Generalized Anxiety Disorder

Anxiety disorder is among the most widespread psychiatric disorders and the most prevalent cause of disability. Although research concerning depression and post-traumatic stress disorder (PTSD) has been commenced, different medications are under investigation for anxiety disorders like Generalized Anxiety Disorder (GAD). GAD is popular among the United States Citizens. According to Simon et al. (2020), the World Health Organization reports that anxiety disorders have impacted about 265 million individuals in the US. As for the pharmacodynamics and pharmacokinetics of anxiolytics and mental health, different medications work on a neurotransmitter in the brain. These medications are critical in ensuring synapses are firing to boost anxiety symptoms and mood. This work intends to highlight the pharmacodynamics and pharmacokinetics of medications and compare and contrast various options of treatment that can be utilized and approved by FAD.

Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) are indicated as one of the essential first-line medications based on their favorable advantage-to-risk ratio. Patients must be aware that the effect of anxiolytics of such antidepressants takes up to approximately 2-4 weeks to show (Kim, 2020). However, the adverse impacts can be more serious in the first two weeks. Original jitteriness and increased anxiety symptoms can happen, thus lowering the patient’s compliance with treatment. In this situation, reducing the beginning of antibodies can improve the side effects. Nonetheless, based on clinical evidence, tolerance differs based on the patient, and the person may suffer fewer side effects if they switch from SSRI to SNRI (Rosenthal & Burchum, 2021, p.246). Furthermore, the withdrawal signs may grow after stopping the therapy of SSRI. However, these symptoms tend to be less common than and serious compared to the withdrawal signs that happen when the medication of benzodiazepine stops.

            When treating anxiety disorder, the imipramine and clomipramine tricyclic antidepressants (TCAs) can be effective and can be termed as 2nd generation antidepressants. On average, TCAs have an increased rate of different side impacts compared to SNRIs and SSRIs (Rosenthal & Burchum, 2021, p. 217). Consequently, before someone utilizes TCAs, there is a need to try these medications. Gradually, as time goes on, the dose of the medication can be increased up to the recommended appointment. Also, based on the possibility of lethal toxicity due to overdose, TCAs must be cautiously administered among patients at high risk of suicide.

Benzodiazepines are highly personalized. To some level, they can be characterized through their metabolism; hence, they should be utilized carefully. They are weak acids that have increased lipophilicity (Van Ameringen et al., 2017). Patients who have a history of benzodiazepine or any substance abuse need not undergo treatment. Benzodiazepines can always be administered in conjunction with SNRIs and SSRIs.

Buspirone, a 5-HT1A agonist grouped as azapirone, is approved by the FDA for treating anxiety. Buspirone is usually an adjunctive treatment with SSRIs and SNRIs, majorly for GAD. According to Van Ameringen et al. (2017), azapirone is the only treatment that can be approved. Buspirone was discovered to be more powerful than placebo. However, it has a reduced effect on GAD compared to antidepressants and benzodiazepines (Rosenthal & Burchum, 2021, p. 229).

In conclusion, individuals with Generalized Anxiety Disorder (GAD) fear different things instead of particular situations or objects, hence the term “generalized” anxiety. This may result in a considerable emotional effect and bodily impact, including muscle tightness and sleepiness. Constant aspects may be taxing. However, different treatments can be essential in reducing anxiety levels, including Buspirone, Benzodiazepines, and tricyclic antidepressants.

 

References

Kim, Y. (2020). Anxiety disorders: Rethinking and understanding recent discoveries. Springer Nature.

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

Simon, N., Hollander, E., Rothbaum, B. O., & Stein, D. J. (2020). The American Psychiatric Association published anxiety, trauma, and OCD-related disorders textbook. American Psychiatric Pub.

Van Ameringen, M., Patterson, B., Turna, J., Pipe, A., & Nakua, H. (2017). The treatment of refractory generalized anxiety disorder. Current Treatment Options in Psychiatry4(4), 404-417. https://doi.org/10.1007/s40501-017-0129-6

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER NURS 6521 Grading Rubric

Performance Category 100% or highest level of performance

100%

16 points

Very good or high level of performance

88%

14 points

Acceptable level of performance

81%

13 points

Inadequate demonstration of expectations

68%

11 points

Deficient level of performance

56%

9 points

 

Failing level

of performance

55% or less

0 points

 Total Points Possible= 50           16 Points    14 Points 13 Points        11 Points           9 Points          0 Points
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic topics.

Presentation of information was exceptional and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was minimally demonstrated in all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in one of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in two of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in three or more of the following elements

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
 16 Points  14 Points  13 Points 11 Points 9 Points  0 Points
Application of Course Knowledge

Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

Presentation of information was exceptional and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was minimally demonstrated in the all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in one of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in two of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in three of the following elements

  • Applies principles, knowledge and information and scholarly resources to the required topic.
  • Applies facts, principles or concepts learned scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
   10 Points 9 Points  6 Points  0 Points
Interactive Dialogue

Initial post should be a minimum of 300 words (references do not count toward word count)

The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)

Responses are substantive and relate to the topic.

Demonstrated all of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 3 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 2 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 1 or less of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
  8 Points 7 Points  6 Points         5 Points          4 Points  0 Points
Grammar, Syntax, APA

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

Error is defined to be a unique APA error. Same type of error is only counted as one error.

The following was present:

  • 0-3 errors in APA format

AND

  • Responses have 0-3 grammatical, spelling or punctuation errors

AND

  • Writing style is generally clear, focused on topic,and facilitates communication.
The following was present:

  • 4-6 errors in APA format.

AND/OR

  • Responses have 4-5 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is somewhat focused on topic.
The following was present:

  • 7-9 errors in APA format.

AND/OR

  • Responses have 6-7 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is slightly focused on topic making discussion difficult to understand.
 

The following was present:

  • 10- 12 errors in APA format

AND/OR

  • Responses have 8-9 grammatical, spelling and punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.
 

The following was present:

  • 13 – 15 errors in APA format

AND/OR

  • Responses have 8-10 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.

AND/OR

  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.
The following was present:

  • 16 to greater errors in APA format.

AND/OR

  • Responses have more than 10 grammatical, spelling or punctuation errors.

AND/OR

  • Writing style does not facilitate communication
  0 Points Deducted 5 Points Lost
Participation

Requirements

Demonstrated the following:

  • Initial, peer, and faculty postings were made on 3 separate days
Failed to demonstrate the following:

  • Initial, peer, and faculty postings were made on 3 separate days
  0 Points Lost 5 Points Lost
Due Date Requirements Demonstrated all of the following:

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

Demonstrates one or less of the following.

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.