NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

Walden University NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

Whether one passes or fails an academic assignment such as the Walden University NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

The introduction for the Walden University NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

After the introduction, move into the main part of the NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

Alzheimer’s disease is defined as a neurological ailment that begins slowly and worsens with time. This health condition is linked to 70% of dementia cases worldwide  (Son et al., 2019). The absence of memory relating to current events is the most common first sign. Other signs of the condition include mood swings, confusion, low self-esteem, linguistic problems, and behavioral abnormalities  (Iniesta et al., 2022). All bodily functions gradually deteriorate, finally leading to death. The important thing to remember is that while Alzheimer’s disease cannot be cured, it may be controlled to improve the patient’s quality of life.  

Summary of Case Presentation 

The media file case study outlines the examination and treatment of Mr. Akkad, a 76-year-old Iranian geriatric man. His eldest son thought he had strange characteristics and was uninterested in religious activities with his family. Furthermore, the patient forgets things, and confabulation was discovered in his case after numerous memory tests. The patient was given the Mini-Mental State Exam, which revealed scores of 18 out of 30 with primary deficiencies in orientation, recognition, attention, and recollection. The result indicates moderate dementia. 

Treatment Decisions 

Exelon 1.5mg twice a day is the most recommended initial intervention based on the patient’s history as stated above. Exelon (rivastigmine) is a medication licensed by the Food and Drug Administration to treat mild to moderate Alzheimer’s disease (Abdel-Atty et al., 2021). Previous research supports the drug’s efficacy and safety profile in the elderly with Alzheimer’s disease  (Ray et al., 2020). The second choice was to increase the Exelon dose to 4.5 mg twice daily, as advised by most clinical practice guidelines for individuals with high tolerance but low efficacy  (Iniesta et al., 2022). The final option was to raise the dosage to 6mg twice daily to encourage maximum success, as the patient still showed limited symptom remission with the earlier intervention (Mirakhori et al., 2022). 

Expected Outcome 

Exelon, when taken correctly, takes between 8 and 12 weeks to completely treat Alzheimer’s symptoms in senior adults, according to evidence  (Son et al., 2019). As a result, the patient was projected to achieve around 50% symptom remission with the first intervention of 1.5mg Exelon twice daily. The dose, however, needed to be titrated to achieve the best results, not exceeding 6mg twice daily (Abdel-Atty et al., 2021). The second and third procedures produced the same results, with no adverse effects. 

Difference Between Expected Outcome and Actual Outcome 

The patient had a small improvement in Alzheimer’s symptoms, as predicted, with no adverse effects noted with the initial intervention  (Ray et al., 2020). After the dose was raised in the second intervention, the patient reported additional symptom remission, but at a slower rate, so the dose was increased in the final intervention, which resulted in optimum remission of Alzheimer’s symptoms, precisely as planned  (Iniesta et al., 2022). 

Also Read:

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

WOMEN’S AND MEN’S HEALTH, INFECTIOUS DISEASE, AND HEMATOLOGIC DISORDERS

OFF-LABEL DRUG USE IN PEDIATRICS

Conclusion  

Alzheimer’s disease is a frequent ailment that affects the elderly’s quality of life and well-being. Exelon was administered to the patient in the case study at a beginning dose of 1.5 mg, which was titrated to 4.5mg, then 6.5mg twice daily. This medicine was quite helpful in managing the patient’s Alzheimer’s symptoms, with no adverse effects recorded. 

References 

Abdel-Atty, M. E. A. E.-F., Khalil, W. F., & Mohamed, S. M. (2021). Effect of Curcumin, Exelon and their Combination on Brain in Alzheimer’s Disease-Induced Rats. Journal of Advances in Medicine and Medical Research, 65–78. https://doi.org/10.9734/jammr/2021/v33i330822 

Iniesta, M., Schurad, B., Koch, C., Schug, B., Morte, A., Vaqué, A., & De la Torre, R. (2022). Comparative Bioavailability Study of a Novel Multi-Day Patch Formulation of Rivastigmine (Twice Weekly) with Exelon® Transdermal Patch (Daily)- A Randomized Clinical Trial. Current Alzheimer Research, 19(7), 541–553. https://doi.org/10.2174/1567205019666220823105059 

Mirakhori, F., Moafi, M., Milanifard, M., & Tahernia, H. (2022). Diagnosis and Treatment Methods in Alzheimer’s Patients Based on Modern Techniques: The Orginal Article. Journal of Pharmaceutical Negative Results, 1889-1907.https://doi.org/10.47750/pnr.2022.13.S01.226 

Ray, B., Maloney, B., Sambamurti, K., Karnati, H. K., Nelson, P. T., Greig, N. H., & Lahiri, D. K. (2020). Rivastigmine modifies the α-secretase pathway and potentially early Alzheimer’s disease. Translational Psychiatry, 10(1). https://doi.org/10.1038/s41398-020-0709-x 

Son, M., Park, C., Rampogu, S., Zeb, A., & Lee, K. (2019). Discovery of Novel Acetylcholinesterase Inhibitors as Potential Candidates for the Treatment of Alzheimer’s Disease. International Journal of Molecular Sciences, 20(4), 1000. https://doi.org/10.3390/ijms20041000 

‌ Sample Answer 2 for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

Introduction

Complex Regional Pain Syndrome (CRPS), a challenging neurological condition, demands a nuanced and evidence-based approach to alleviate suffering and enhance patients’ quality of life. This in-depth analysis delves into the intricate case of a 43-year-old white male diagnosed with CRPS in his right hip. Through a series of carefully considered decisions, this patient’s journey sheds light on the complexities of managing CRPS while balancing medication side effects and therapeutic outcomes.

Patient Summary

The patient’s ordeal commenced seven years ago, following a fall at work resulting in significant right hip injury. Despite extensive diagnostic tests, he faced skepticism from healthcare professionals, leading to delays in appropriate treatment. The decisions taken included initiating amitriptyline at 25 mg, titrating to 125 mg at bedtime, and later reducing the dosage to 100 mg daily. These decisions were geared towards mitigating pain, enhancing functionality, and minimizing side effects such as grogginess and weight gain.

Evidence-Based Support for Decisions

The initiation of amitriptyline aligns with studies demonstrating its efficacy in managing neuropathic pain, particularly CRPS (Neyama et al., 2020). Amitriptyline, a tricyclic antidepressant, modulates pain perception through multiple pathways, making it a cornerstone in neuropathic pain management (Solomon et al., 2022). The decision to maintain the dose despite minor weight gain is substantiated by research indicating that the benefits of pain control often outweigh modest side effects (Naguib et al., 2021). Additionally, the avoidance of Qsymia was prudent, considering its potential cardiac risks and the patient’s BMI falling below the recommended threshold for its use (Lei et al., 2021).

In addition to pharmaceutical interventions, exploring alternative therapies such as neuromodulation techniques has gained significant attention. A comprehensive study by Sivanesan, & Goebel (2021) delves into the effectiveness of spinal cord stimulation and peripheral nerve stimulation in managing Complex Regional Pain Syndrome, providing valuable insights into diverse treatment modalities.

Goals and Outcomes

The overarching goal was to reduce the patient’s pain levels to an acceptable threshold (around 3 on the scale) and restore his ability to perform daily activities without crutches. The outcomes were remarkably positive; the patient’s pain diminished from a debilitating 9 to a manageable 4. This reduction facilitated enhanced mobility and daily functioning, marking a significant improvement in his overall well-being. Despite minor weight gain, the patient’s improved quality of life underscored the success of the interventions.

Discrepancies Between Expectations and Results

In this case, the outcomes closely mirrored the expectations. The patient experienced a substantial reduction in pain, improved functionality, and minimal side effects, including manageable weight gain. The decisions made successfully struck a delicate balance between therapeutic benefits and potential drawbacks, ensuring the patient’s optimal quality of life. The minor weight gain, while a concern, was overshadowed by the vast improvements in pain control and functionality, aligning with the patient’s stated preferences.

Conclusion

CRPS management necessitates a holistic and individualized approach, integrating evidence-based practices, patient preferences, and vigilant monitoring of outcomes. This case study underscores the pivotal role of healthcare providers in navigating the complexities of CRPS treatment. By employing a comprehensive understanding of available therapies and their potential effects, clinicians can significantly enhance the lives of individuals afflicted with this debilitating condition.

References

Lei, X., Ruan, J., Lai, C., Sun, Z., Yang, X., Lei, X.-G., & Ruan, J.-Q. (2021). Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis. Obesity (19307381), 29(6), 985–994. https://doi.org/10.1002/oby.23152

Naguib, I. A., Ali, N. A., Elroby, F. A., & Elghobashy, M. R. (2021). Green HPLC-DAD and HPTLC Methods for Quantitative Determination of Binary Mixture of Pregabalin and Amitriptyline Used for Neuropathic Pain Management. Journal of Chromatographic Science, 59(6), 536–547. https://doi.org/10.1093/chromsci/bmab031

Neyama, H., Dozono, N., Uchida, H., & Ueda, H. (2020). Mirtazapine, an α 2 Antagonist-Type Antidepressant, Reverses Pain and Lack of Morphine Analgesia in Fibromyalgia-Like Mouse Models. The Journal of Pharmacology and Experimental Therapeutics, 375(1), 1–9. https://doi.org/10.1124/jpet.120.265942

Sivanesan, E., & Goebel, A. (2021). Complex regional pain syndrome: developing diagnostic tools and treatments from sympathetic nervous system, neuroimmune and neuromodulation discoveries in neuropathic pain. Regional Anesthesia & Pain Medicine, 46(3), 193–195. https://doi.org/10.1136/rapm-2020-101644

Solomon Tesfaye, Gordon Sloan, Jennifer Petrie, David White, Mike Bradburn, Tracey Young, Satyan Rajbhandari, Sanjeev Sharma, Gerry Rayman, Ravikanth Gouni, Uazman Alam, Steven A Julious, Cindy Cooper, Amanda Loban, Katie Sutherland, Rachel Glover, Simon Waterhouse, Emily Turton, Michelle Horspool, … Dinesh Selvarajah. (2022). Optimal pharmacotherapy pathway in adults with diabetic peripheral neuropathic pain: the OPTION-DM RCT. Health Technology Assessment, 26(39). https://doi.org/10.3310/RXUO6757

1. Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.

Mr. Akkad, an Iranian man in his 76th year, has been displaying odd habits and cognitive deterioration over the past two years. His family has observed psychological changes in him, such as a decline in religious pursuits, an uptick in criticism of others, and a propensity to find humor in serious issues. He has also been having issues with his memory and finding the correct words to use in talks. Mr. Akkad scored 18 out of 30 on the Mini-Mental State Exam during the clinical interview, indicating deficiencies in orientation, registration, attention & calculation, and recall. His tangential speech, constrained affect, reduced insight, and poor impulse control were all discovered during his mental status examination.

Three decisions for Mr. Akkad were made:

• Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive).
• The initiation of cognitive assessment and interventions.
• Consideration of possible medication management for Alzheimer’s disease.

2. Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

• This choice is consistent with Mr. Akkad’s clinical presentation, which shows cognitive decline, memory impairments, and impaired orientation. A tentative diagnosis can direct first care while a conclusive diagnosis might necessitate additional neuropsychological testing. A commonly used diagnostic guide, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides criteria for the main neurocognitive disorders, such as Alzheimer’s disease, based on clinical evaluation and proof of cognitive impairment. For significant neurocognitive disorders, the DSM-5 criteria, for instance, offer suggestions for diagnosis. Among these requirements is proof of cognitive impairment, which Mr. Akkad possesses.
• It is consistent with evidence-based strategies for managing Alzheimer’s disease to suggest cognitive evaluation and therapies. The management of cognitive problems depends heavily on early diagnosis and therapies. Both cognitive training and cognitive stimulation therapy have been proven to be beneficial in preserving cognitive function and enhancing quality of life in dementia patients. For instance, cognitive training and rehabilitation may be advantageous for those with mild to severe Alzheimer’s disease and vascular dementia, according to a systematic study published in the Cochrane Database of Systematic Reviews (Bahar-Fuchs et al., 2019).
• Evidence is in favor of taking medication management into account for Alzheimer’s. Memantine and other cholinesterase inhibitor drugs, including donepezil, are frequently recommended to treat the cognitive symptoms of Alzheimer’s disease. These drugs can be used to control cognitive symptoms and delay cognitive decline in Alzheimer’s disease, according to research and clinical recommendations. For instance, a Cochrane systematic review (Birks, 2006) demonstrates the effectiveness of cholinesterase inhibitors for Alzheimer’s disease and suggests their potential to maintain patients’ quality of life while enhancing cognitive performance.

3. What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources. 

• To start early intervention, the presumptive diagnosis of a serious neurocognitive problem caused by Alzheimer’s disease was made. Early diagnosis is essential because it enables prompt treatment and intervention commencement, both of which have the ability to decrease the trajectory of cognitive decline. Livingston et al.’s (2017) study emphasizes the significance of early Alzheimer’s disease diagnosis and the possible advantages it offers in terms of enhancing patient and family quality of life.
• Recommending cognitive assessments and treatments to address the cognitive decline Mr. Akkad’s has. According to Bahar-Fuchs et al. (2019), early therapies like cognitive stimulation therapy and cognitive training can assist control cognitive symptoms and retain cognitive function to some extent. These treatments are necessary to enhance the patient’s quality of life and preserve their functional independence.
• It is consistent with evidence-based practices to take drug treatment for Alzheimer’s disease into consideration. To treat the cognitive symptoms of Alzheimer’s disease, doctors frequently give drugs such cholinesterase inhibitors (such as donepezil) and memantine (Birks, 2006). Although individual reactions can vary, some drugs may help slow cognitive decline and enhance cognitive performance.

4. Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

1. Presumptive Diagnosis of Major Neurocognitive Disorder due to Alzheimer’s Disease
   • Expected Outcome – The desired result was to offer a preliminary diagnosis to direct future evaluation and treatment. The cornerstone for developing the most suitable interventions would be this diagnosis.
   • Result – The exercise provided a “presumptive” diagnosis, noting that additional neuropsychological testing would be necessary for a certain diagnosis. Given that the exercise only offered a preliminary evaluation, this is in line with expectations.
2. Initiation of Cognitive Assessment and Interventions
   • Expected Outcome – A cognitive examination and therapies were to be started in order to address cognitive decline, preserve cognitive function, and enhance Mr. Akkad’s quality of life.
   • Result – The exercise’s recommendation was to start a cognitive assessment and interventions. Although the exercise did not specify the precise actions, it was anticipated that, after more review, a thorough assessment and intervention plan would be created.
3. Consideration of Medication Management for Alzheimer’s Disease
   • Expected Outcome – Taking into account medication management, particularly the use of cholinesterase inhibitors or memantine, which are popular therapies for Alzheimer’s disease’s cognitive symptoms, was expected.
   • Result – In line with expectations, the exercise suggested thinking about drug treatment for Alzheimer’s disease. The exercise did not indicate whether medication was to be given right away, since this decision would need to be made after additional testing and consultation with Mr. Akkad and his family.

References:

• Livingston, G., Sommerlad, A., Orgeta, V., et al. (2017). Dementia prevention, intervention, and care. The Lancet, 390(10113), 2673-2734.
• Bahar-Fuchs, A., Clare, L., & Woods, B. (2019). Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer’s disease and vascular dementia. Cochrane Database of Systematic Reviews, 3(3), CD003260.
• Birks, J. S. (2006). Cholinesterase inhibitors for Alzheimer’s disease. Cochrane Database of Systematic Reviews, 1(1), CD005593.
• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
• Alzheimer’s Association. (2019). Alzheimer’s disease: Treatment. Retrieved from https://www.alz.org/alzheimer’s-dementia/treatments 
• Alzheimer’s Association. (2019). Medications for Memory Loss. Retrieved from https://www.alz.org/alzheimer’s-dementia/treatments/medications-for-memory-loss

NURS 6521 Week 8: generalized anxiety disorder  

The most prevalent kind of mental illness and a primary contributor to people’s inability to work is generalized anxiety disorder, sometimes known as GAD (Garakani et al., 2020). It is a severe form of persistent anxiety and worries about several aspects of a person’s life, such as their job, school, family, and connections with other people. Symptoms such as extreme weariness, restlessness, difficulty concentrating, forgetfulness, irritability, sleep impairment, tachycardia, and sweating are common indicators of this condition. The majority of the time, a person who suffers from generalized anxiety disorders also has additional mental diseases, such as major depressive disorder, obsessive-compulsive disorder, and anti-social tendencies (Patriquin & Mathew, 2017). 

The anxiety disorder known as generalized anxiety disorder (GAD) can be treated in a variety of methods, such as through individual treatment, group therapy, and the management of medication. Non-pharmacological management involves psychotherapy and the development of coping strategies to deal with stressful events that have the potential to bring on anxiety episodes. Some examples of these skills include relaxation breathing exercises and cognitive behavioral therapy (CBT). A number of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been granted approval by the Food and Drug Administration (FDA) for the treatment of generalized anxiety disorder (GAD) (Garakani et al., 2020). 

The first-line medication for generalized anxiety disorder (GAD) is called selective serotonin reuptake inhibitors (SSRIs), and it works by preventing the reuptake of serotonin. The hormone serotonin is responsible for maintaining a person’s consistent state of mind. By inhibiting the serotonin uptake receptor, more serotonin will be available in the synaptic cleft. This will allow for greater stimulation of the neurons by increasing the levels of serotonin that are available, which in turn can affect an individual’s mood and assist with the treatment of anxiety disorders. Due to an increased risk of severe side effects, SSRIs are typically not suggested for the following groups of people: women who are pregnant or breastfeeding; children under the age of 18; anyone who have diabetes, epilepsy, or kidney illness (National Health Services, 2021). 

As the first antidepressant to receive FDA approval for the treatment of generalized anxiety disorder (GAD), venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI). Patients with or without concomitant disorders like depression are eligible for treatment with this modality. It takes about a week for a patient to begin to feel the effects of this treatment because it is not a quick fix. As a result, it is not a good option to go with in a critical situation. Weaning off of this medicine needs to be done cautiously in order to avoid withdrawal symptoms, just like benzodiazepine does. When taken in high doses, the adverse impact is likely to cause hypertension. It is not recommended to take venlafaxine in conjunction with a monoamine oxidase inhibitor (MAOI). Insomnia, nausea, sweating, and headaches are some of the other potential adverse effects (Rosenthal & Burchum, 2018). 

Escitalopram is a type of SSRI that has also been approved for the treatment of GAD. This medication may be prescribed to individuals who have or do not have concomitant illnesses such as depression. Alternative treatment for anxiety that is superior to benzodiazepines in terms of its ability to alleviate both the physical and mental symptoms of the condition. Nausea, perspiration, headaches, and sleeplessness are some of the adverse effects (Rosenthal & Burchum, 2018). 

The body’s stomach pH progressively decreases with age, which can limit the pace at which a medicine is absorbed into the body in older adults. Imagine that the drug has been given the green light to be prescribed to those of advanced age. If this is the case, medical professionals need to start prescribing smaller doses first for elderly patients because increasing the dosage too much can raise the danger of overdosing. Because they reduce the likelihood of adverse effects in comparison to other antidepressants, selective serotonin reuptake inhibitors (SSRIs) are the antidepressants of choice for older persons to be prescribed (American Psychological Association, 2019). 

Benzodiazepines are an additional favored pharmacological class for the treatment of anxiety disorders. These drugs function by enhancing the response of the body to gamma-aminobutyric acid. It has a rapid onset of action and a large margin of safety while inhibiting neurotransmitters. (Rosenthal & Burchum, 2018). There is a growing propensity towards inappropriate behavior. Patients who have a history of abusing substances such as cocaine, heroin, alcohol, or opioids should have their usage of this medication closely monitored due to the possibility of addiction (Drug Enforcement Agency, n.d). Some patients may suffer sedative effects after beginning treatment with this medication, which manifests itself as a slowing of both mental and physical activity. Patients need to be educated so that they understand that they should continue taking their prescription even if they have these side effects, since they will pass within seven to ten days. Patients who are taking benzodiazepines should also be educated not to suddenly stop taking the drug as this could result in withdrawal symptoms such as delirium, panic episodes, and paranoia. Patients should be educated not to suddenly stop taking the medication. The dosage of the medicine needs to be gradually decreased by the practitioner. Lorazepam and Alprazolam are two examples of different kinds of benzodiazepines. Each has a suggested dosage that the practitioner must administer, taking into account the patient’s adherence to treatment as well as the patient’s health insurance (Rosenthal & Burchum, 2018). 

Buspirone 

Buspirone is a medication that is used to treat anxiety, and unlike benzodiazepines, it does not have a depressive effect on the central nervous system. Buspirone is a partial agonist for the 5-HT1A receptor and is categorized as an azapirone. It is FDA-approved for the treatment of anxiety and is most frequently used in conjunction with SSRIs or SNRIs, primarily for the treatment of GAD (Garakani, et al., 2020). Buspirone binds to dopamine receptors with a lower affinity than it does to serotonin receptors, which it does with a high affinity. Patients who have a history of abusing drugs or alcohol do not need to be monitored as frequently, and they are not subject to the regulations of the Controlled Substances Act. This makes it a safer option. According to the findings of a Cochrane study on the use of buspirone for generalized anxiety disorder (GAD), the medication was more effective than the placebo but had a smaller effect size in GAD than benzodiazepines and antidepressants (Garakani et al., 2020). If a patient is transitioning off of benzodiazepines, it is okay for them to begin taking buspirone two to four weeks before beginning the weaning process off of the benzodiazepine. In addition, it does not exhibit the withdrawal symptoms that are associated with benzodiazepines. Buspirone’s absorption can be slowed down by taking it with meals; yet, the drug’s bioavailability can rise as first-pass metabolism is decreased. While using Buspirone, increasing your grapefruit juice consumption or taking antibiotics like erythromycin or ketoconazole can cause your level to rise, which can lead to feelings of tiredness and dysphoria. Other side effects include headaches, nausea, lightheadedness, dizziness, and vomiting (Rosenthal & Burchum, 2018). 

References 

American Psychological Association. (2019). Depression treatments for older adults. Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts. https://www.apa.org/depression-guideline/older-adults 

Drug Enforcement Agency, (n.d.). Drug fact sheet: Benzodiazepines. https://dev9.dea.gov/sites/default/files/2020-06/Benzodiazepenes-2020_1.pdf  

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 psychiatry, 11, 595584. https://doi.org/10.3389/fpsyt.2020.595584  

Munir, S. (2022). Generalized anxiety disorder.  https://www.ncbi.nlm.nih.gov/books/NBK441870/  

Patriquin, M. A., & Mathew, S. J. (2017). The neurobiological mechanisms of generalized anxiety disorder and chronic stress. Chronic Stress, 1, 247054701770399. https://doi.org/10.1177/2470547017703993  

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. Elsevier.