Pharmacology Assignment: Pharmacology Exam 2 Discussion Analysis

This pharmacology assignment presents discussions related to several health issues. The first section addresses depression and the use of SSRIs, including potential side effects, and includes a reflection on a personal experience with a depressed patient. The second part focuses on obesity, examining its causes, the use of medication, and the impact on healthcare costs. The third section discusses pulmonary embolism, covering its pathophysiology and treatment with low molecular weight heparin, including monitoring and patient education. The final section addresses heart disease, exploring social and cultural factors affecting care, nursing interventions, and essential information for patients. Each section includes references to supporting research and literature.

Running head: PHARMACOLOGY ASSIGNMENT
PHARMACOLOGY ASSIGNMENT
Name of the student:
Name of the university:
Author note:

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Discussion: exam 2 anti-depression medications:
Question 1:
Drug therapy with an SSRI helps reduce the symptoms of the depression by improving
mood as it increases the extracellular level of serotonin (Russell et al., 2017). In this context, his
mother can experience elevated mood, increased appetite and improved social connection.
(Bushnell et al., 2018). While involving in the therapy, his mother can learn about the symptoms
of depression, the creation of safe environments by eliminating certain items (weapons and
medications). His mother may expect certain side effects of the medication and seeking the help
of the professionals may resolve the issue
Question 2:
The pediatric patients often experience gastrointestinal symptoms such as stomach upset,
nausea and diarrhea. Dwyer et al. (2020), suggested that pediatric patients also experience
headache, blurred vision and anxious while administrated with Selective Serotonin Reuptake
Inhibitor. Therefore, while administrating the medication, the professionals must consider these
side effects of the medications and administrate medication in the optimum dose. Hogg et al.
(2016), highlighted that children and teenager often exhibit an increased level of suicide ideation.
Therefore, while administration the medication, it is crucial to ensure that the pediatric patient
does not experience an increased level of suicidal ideation and commit suicide.
Question 3:
Experience of working with a depressed person:

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While placed in the clinical placement, I have interacted with an elderly depressed patient
with diabetic foot ulcer whose husband died 2 years ago. Smith et al., (2018) suggested that
patients with diabetes often feel helpless, hopelessness, loss of appetite, loneliness and
worthlessness. The patient I interacted with often experienced demotivation, lonely and hopeless.
In this context, I communicated with the patient daily and developed a therapeutic relationship so
that she feels empowered and gain motivation to live a healthy life.

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References:
Bushnell, G. A., Compton, S. N., Dusetzina, S. B., Gaynes, B. N., Brookhart, M. A., Walkup, J.
T., ... & Stürmer, T. (2018). Treating pediatric anxiety: Initial use of SSRIs and other
anti-anxiety prescription medications. The Journal of clinical psychiatry, 79(1).
Dwyer, J. B., Stringaris, A., Brent, D. A., & Bloch, M. H. (2020). Annual Research Review:
Defining and treating pediatric treatment‐resistant depression. Journal of Child
Psychology and Psychiatry, 61(3), 312-332.
Hogg, S., Ansari, S., Masood, Q., Agius, M., & Rihmer, Z. (2016). Are SSRIs responsible for
precipitating suicidal ideation in teenagers with'subsyndromal'bipolar affective disorder
who have been misdiagnosed with unipolar depression?. Psychiatria Danubina, 28(Suppl
1), 79-82.
Russell, J. L., Spiller, H. A., Chounthirath, T., & Casavant, M. J. (2017). Pediatric ingestion of
vilazodone compared to other selective serotonin reuptake inhibitor medications. Clinical
Toxicology, 55(5), 352-356.
Smith, L., White, S., Stubbs, B., Hu, L., Veronese, N., Vancampfort, D., ... & Yang, L. (2018).
Depressive symptoms, handgrip strength, and weight status in US older adults. Journal
of affective disorders, 238, 305-310.

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Discussion exam 2:
Question 1:
Experience of obesity:
Supersize me is an American documentary film directed in 2004 where the lead
character from New York ate only McDonald's for 30 Days which resulted in serious health
issues as he doctor suggested that he was experiencing irreversible heart damage. Considering
the personal experience, consuming excessive fast food containing lipid, unrefined carbohydrate
directly contributed to obesity. One of my school friend currently experiencing cardiac issues
and diabetes due to obesity. He exhibited unhealthy diet such as excessive consumption of fast,
binge eating of snakes along with excessive consumption of food.
Question 2:
Consumption of medication in obesity:
As discussed by Srivastava et al. (2019), individuals with obesity often experience
cardiac issues, altered metabolism and increased cholesterol associated problem. Therefore, in
order to address the issues developed due to overweight amongst patients can be resolved
through consumption of medications such as blood pressure medications and medication for
reducing cholesterol. Therefore, for management of these mental health issues, use of medication
is also crucial. However, a non-pharmacological intervention can reduce obesity and associated
disease along with medication consumption (Lawman et al., 2016).Altering the diet by
incorporating vegetables, fruits and low carbohydrate food can reduce the weight, improve mood
and reduce other health issues associated with obesity which in turn reduce medication
consumption.

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Question 3:
Obesity influence the health care cost:
As discussed by Price et al. (2019), obesity individuals often experience cardiac issues,
Stroke, altered metabolism,. According to the center of disease control and prevention, the health
care cost of obesity in the United States is higher compared to other countries (Www.cdc.gov.,
2020). The average estimation of costs for obesity and associated health disease is $147 billion.
In United States, hemodialysis care cost per year is approximately $72,000- $88,782 (Axelrod et
al., 2018)

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References:
Axelrod, D. A., Schnitzler, M. A., Alhamad, T., Gordon, F., Bloom, R. D., Hess, G. P., ... &
Naik, A. S. (2018). The impact of direct‐acting antiviral agents on liver and kidney
transplant costs and outcomes. American Journal of Transplantation, 18(10), 2473-2482.
Lawman, H. G., D. Fryar, C., Gu, Q., & Ogden, C. L. (2016). The role of prescription
medications in the association of self‐reported sleep duration and obesity in US adults,
2007‐2012. Obesity, 24(10), 2210-2216.
Price, P. H., Kaizer, A. M., Daniels, S. R., Jenkins, T. M., Inge, T. H., & Eckel, R. H. (2019).
Physical Activity Improves Lipid and Weight‐Loss Outcomes After Metabolic Bariatric
Surgery in Adolescents with Severe Obesity. Obesity, 27(6), 989-996.
Srivastava, G., Fox, C. K., Kelly, A. S., Jastreboff, A. M., Browne, A. F., Browne, N. T., ... &
Lenders, C. M. (2019). Clinical considerations regarding the use of obesity
pharmacotherapy in adolescents with obesity. Obesity, 27(2), 190-204.
Www.cdc.gov. (2020). Adult Obesity Causes & Consequences | Overweight & Obesity | CDC.
Retrieved 10 April 2020, from https://www.cdc.gov/obesity/adult/causes.html

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DISCUSSION EXAM 2: Thrombosis
Question 1:
The chosen disease is pulmonary embolism. Considering pathophysiology, it can be said
that pulmonary embolism occurs when deep venous thrombi detach as well as emblaze to the
pulmonary circulation (Hao et al., 2016). Consequently, pulmonary vascular occlusion observed
simultaneously with impaired gas exchange and circulation. As the systolic pressure of
pulmonary artery increases, after a load of right ventricular simultaneously increases that
resulted in right ventricular failure.
Question 2:
In order to reduce pulmonary thrombosis, low molecular weight heparin would be the
most suitable drug of choice that can reduce blood clot. Anticoagulant therapy with heparin
therefore effective in reducing the mortality rate from 30% to 10%. The heparin could enhance
the inhibitory activity of the plasma protein anti-thrombin against a range of serine proteases of
the coagulation system (Gavura, Bayliff & Kovacs, 2018). Therefore, it is effective in reducing
pulmonary embolism. In order to monitor the pulmonary embolism, blood test and chest X-ray
is required to conduct for assessing the presence of thrombosis. Additionally, CT pulmonary
angiography is another effective way to assess the presence of thrombosis in pulmonary
embolism.
Question 3:
While administrating heparin the nurses are required to provide with the patient
education regarding safe administration of medication. The literacy must be provided regarding
safe injection of heparin under the skin or infusion into a vein. The literacy must be provided

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regarding the management of nose bleeding and unexpected bowel movement as patients often
experience nose bleeding followed by an unexpected bowl movement (Plautz et al., 2018).

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References:
Gavura, S., Bayliff, C. D., & Kovacs, M. J. (2018). Evaluation of a Heparin Nomogram in the
Treatment of Deep Vein Thrombosis and Pulmonary Embolism. The Canadian Journal
of Hospital Pharmacy, 50(3).
Hao, Q., Dong, B. R., Yue, J., Wu, T., & Liu, G. J. (2018). Thrombolytic therapy for pulmonary
embolism. Cochrane database of systematic reviews, (12).
Plautz, W. E., Sekhar Pilli, V. S., Cooley, B. C., Chattopadhyay, R., Westmark, P. R., Getz,
T., ... & Majumder, R. (2018). Anticoagulant protein S targets the factor IXa heparin-
binding exosite to prevent thrombosis. Arteriosclerosis, thrombosis, and vascular
biology, 38(4), 816-828.

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DISCUSSION EXAM 2: Heart Disease (#4 Discussion question for Exam 2)
Question 1:
The common social issues affect the care of all people with heart disease include lack of
social support, low socioeconomic status and the stress at work and family life. These factors
worsen the care process provided to heart disease (Ishigami et al., 2017). The common cultural
factors with the care for heart disease is that in many cultures, smoking is considered as the
traditional which impacted the care process. The additional cultural factors that influence the
care process cultural diet, ethnic background, cultural beliefs and rate of blood pressure
depending on the ethnicity (Mendenhall et al., 2017).
Question 3:
The statin medications not only reduce high serum cholesterol and high triglycerides but
also prevent a range of different heart disease. In this context, the primary role of a registered
nurse is to ensure proper administration of statin with accurate dose so that no abnormal vital
signs observed. Additionally, since statin may increase heartbeat, nursing professionals must
assess the heart rate continuously so that heart disease can be preventing (Sillman et al., 2017).
Moreover, registered nurses are required to alter diet by eliminating fat-containing food and
incorporating vegetables and fruits. The patient can be involved in physical activity for
preventing heart disease.
Question 4:
The common critical information that is required to provide to the patient is to manage
common side effects such as dry mouth, muscle pain, abdominal pain and nausea. Other critical

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information would be a modification of lifestyle while taking medications such as elimination of
high fat and sodium from the diet (Sillman et al., 2017).
References:
Ishigami, S., Ohtsuki, S., Eitoku, T., Ousaka, D., Kondo, M., Kurita, Y., ... & Horio, N. (2017).
Intracoronary cardiac progenitor cells in single ventricle physiology: the PERSEUS
(Cardiac Progenitor Cell Infusion to Treat Univentricular Heart Disease) randomized
phase 2 trial. Circulation research, 120(7), 1162-1173.
Mendenhall, E., Kohrt, B. A., Norris, S. A., Ndetei, D., & Prabhakaran, D. (2017). Non-
communicable disease syndemics: poverty, depression, and diabetes among low-income
populations. The Lancet, 389(10072), 951-963.
Sillman, C., Morin, J., Thomet, C., Barber, D., Mizuno, Y., Yang, H. L., ... & Balon, Y. (2017).
Adult congenital heart disease nurse coordination: Essential skills and role in optimizing
team-based care a position statement from the International Society for Adult Congenital
Heart Disease (ISACHD). International journal of cardiology, 229, 125-131.