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- Please answer every question by responding with 1A), 2A), 1B), 2B), etc. You will not be graded on these.
- Do not forget to add a brief summary of the articles, as well as, something learned from them or how it will impact your practice.
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Article A:
1A) What percentage of patients are expected to have possible EPS reactions from haloperidol (Stetson & Osser, 2022, p.172)?
a. 35% b. 25% c. 50% d. 90%
2A) What percentage of patients are expected to have possible EPS reactions from haloperidol and lorazepam (Stetson & Osser, 2022, p. 173)?
a. 20% b. 30% c. 80% d. 5%
Article B:
1B) True or False. Higher inflammation hampers response to antidepressants, and effective antidepressant treatment decreases inflammation (Benedetti et al., 2022, p.79).
Citations:
Article A)
Stetson, S. R., & Osser, D. N. (2022). Psychopharmacology of agitation in acute psychotic and manic episodes. Current Opinion in Psychiatry, 35(3), 171–176. https://doi.org/10.1097/yco.0000000000000787
In-text Citation: (Stetson & Osser, 2022)
Article B)
Benedetti, F., Zanardi, R., & Mazza, M. G. (2022). Antidepressant psychopharmacology: Is inflammation a future target? International Clinical Psychopharmacology, 37(3), 79–81. https://doi.org/10.1097/yic.0000000000000403
In-text Citation: (Benedetti et al., 2022)
Summary A) : Agitation is a factor that can occur at any point throughout the hospital stay. A ranking of the common medical interventions was reviewed and was ranked based on efficiency under a two-hour time frame.
I found the ranking based on efficiency to be helpful when considering other options that are not listed as PRN.
Summary B): Inflammation biomarkers have been noted to be increased in patients suffering from depression. These biomarkers can also indicate a variety of other brain functions and impact treatment on a patient.
I found it interesting how SSRIs can affect platelets as well and with that can stop platelets from activating and clotting.
I agree that the ranking is helpful. I didn’t realize there were so many different options.
I think it is interesting the more we learn about the human body, the more intertwined all the different systems are.
Article A
1A: C-50%
2A: D. 5%
Article B
1B: True
Summary A): There are many different options available for the medical management of patients experiencing agitation. Although studies have been conducted on these medication options, information obtained is often difficult to interpret due to numerous study limitations in regards to agitated patients. I find it interesting that there is no obvious gold standard in choosing a medication to help with acute agitation. Each medication has their own advantages and disadvantages that has to be taken into consideration and the tier system is helpful in making a selection.
Summary B): Major depression is associated with increased inflammation markers. Higher levels of inflammation decrease a person’s response to anti-depressant medications. Newer pharmacologic treatments for immune-mediated inflammatory diseases are in the process of being tested.
On behalf of Stephanie Dunn (computer issues):
1A) c. 50%
2A) d. 5%
1B) True
We deal with a lot of psychotic and manic patients on 8WD who self mutilate themselves so this information will be helpful in my nursing practice. The first article was helpful in teaching that haloperidol with lorazepam, lorazepam alone, and olanzapine are the best options for oral treatment of manic and psychotic patients. And it is helpful to know in acute events where an IM option is needed, that haloperidol plus promethazine and olanzapine alone is what the nursing staff should attempt to administer first. Nursing staff can now suggest some PRN’s to the MDs covering to help de-escalate situations faster.
The second article was interesting to learn that patients with depression have been found to have these increased inflammatory markers present. This could change the way we treat depression for the future.
Stephanie, I also appreciate having some medication options to recommend for faster de-escalating acute agitation.
great choice in articles.
1A) C 50%
2A) D 5%
1B) True
Summary A
We frequently deal with psychiatric patients on our unit, so I was interested to read about the Tier system when it comes to deciding which medications would possibly be most effective. Even with the Tier system though there still are so many advantages/disadvantages to each medication which must be considered by providers. I was also surprised to learn that Phenergan could be used IM for agitation.
Summary B
I was surprised to learn the relationship between inflammation and the efficacy of anti-depressants. I could see in the future that maybe depression could be treated more holistically rather than just one medication being prescribed.
1A) C 50%
2A) D 50%
1B) True
Summary A
On the prison unit dealing psychiatric patients is very common. It was interesting to read about the tier system for acute agitation. It was also interesting to read that Haloperidol is not be used alone due to EPS unless other medications are unavailable. We often use it alone in acute agitation on our unit so I may bring this study up in the future.
Summary B
Antidepressants are prescribed frequently for my patients with depression. It was interesting to learn about that treatments targeting inflammation may be warranted for use as antidepressants in the future. I am definitely interested to see where this goes in the future.
Michele, I am also interested to see what this means for the future of antidepressants.
Article A- Review of medications used to manage agitation in acute psychotic and manic episodes. I found this review helpful and over the years I personally have not seen some of these medication combinations used.
Answer 1A-c 50%
2A-D 5%
Article B-Inflammation setpoints and how it affects patients with depression, BPAD, and their response to medications. Very interesting.
1B-true