Psychopharmacology: Case-Study Sample Paper
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Consider the cholinergic system as a potential source of Pat?s problems. What examples/ pieces of information from the case report would support this conclusion?
The cholinergic system is a structure of nerve cells that applies acetylcholine to transfer nerve impulses, it is the neurotransmitter system associated with control of memory, sensory and motor skills and learning. If this system deteriorates it leads to the onset of Alzheimer?s disease (Li et al. 2018). From the case study, it is evident Pat has a challenge holding a conversation, her thoughts wander perpetually during the interview and often forgets mundane things and are occasionally distracted. It is inarguable that the cholinergic system is a potential source of Pat?s problems. The symptoms listed above indicate Pat has a difficulty with the transmission of her nerve impulses which might be due to the degeneration of her cholinergic system.Psychopharmacology: Case-Study Sample Paper
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What are the main types of cholinergic receptors? How might they relate to some of the symptoms described in the case report? (Select and explain at least 2 examples) (4 pts)
Cholinergic means associated with acetylcholine, which is a neurotransmitter discharged from both the preganglionic and the postganglionic neurons of the parasympathetic unit (Blanchard et al. 2018). There are two types of cholinergic receptors also referred to as acetylcholine receptors (AChR) that fasten acetylcholine and send its signal; they include muscarinic receptors and nicotinic receptors (Nissen et al. 2018).
Nicotinic cholinergic receptors are involved in the signal transmission at synapses which enable the cognitive functions, motor skills, memory, and learning. When nicotinic receptors are bonded with acetylcholine it activates them and excites muscle cell to produce muscular contraction. This relates to the symptoms related in the case study, Pat is losing some of her motor skills, hearing and ability to hold a conversation. The nicotinic cholinergic receptors in her body are failing thus the deterioration of her well-being.Psychopharmacology: Case-Study Sample Paper
What type of medication might be helpful for Pat? Why? How does it act pharmacologically to increase or decrease cholinergic function? (3 pts)
From the case study it is evident that the previous medication prescribed to Pat did not work and in fact worsened her condition. The anti-psychotics actually worsened her memory problems and caused xerostomia, moreover; she was hospitalized for delusional thinking and increasing paranoia. The above side effects are caused by anti-depressants and anti-anxiety medication (Iyer et al. 2018). It is also noted that Pat indulges in smoking which is also known to harm the memory function since it minimizes the supply of oxygen to the brain.
I would highly recommend acetylcholinesterase inhibitor (Aricept), this is a prescription that enhances memory and attention, and it is also approved to treat Alzheimer?s disease. Acetylcholinesterase inhibitors merge with the enzyme as their core target and are prescribed as toxins and admissible drugs. These inhibitors act pharmacologically by increasing the level and duration of activity by the neurotransmitter; they achieve this by inhibiting the cholinesterase enzyme from breaking down (Gao et al. 2018).
Reconsidering the case report, is there another potential neurotransmitter system you think could explain any of the aspects described?
A neurotransmitter is a chemical element released by the body for purposes of neurotransmission or synaptic transmission. Neurotransmitters are categorized as either inhibitory or excitatory, inhibitory neurotransmitters have a reverse mechanism action; they deactivate receptors and lessen the effect of activity or mobility. On the other hand, excitatory neurotransmitters arouse receptors on the postsynaptic membrane and improve the efficiency of the action potential.
There are two neurotransmitters that could work for Pat to remedy her health, one of them is serotonin; this is an inhibitory neurotransmitter whose purpose is to stabilize the mood. Sufficient doses of serotonin are administered to balance any effects caused by extreme excitatory neurotransmitters in the brain. Pat is constantly in pain, is always moody or agitated and has a range of anger management issues if serotonin is prescribed it could help even her out.
The second neurotransmitter that can be used is norepinephrine; also called noradrenaline, it is an excitatory neurotransmitter released by the adrenal glands. Its main purpose is to heighten the level of alertness of the nervous structure and trigger the processes in the body (Perry, 2018).Psychopharmacology: Case-Study Sample Paper Norepinephrine can be used as a remedy for Pat?s case, the confirmed difficulties with memory and attention can be corrected by administering this neurotransmitter.
The two neurotransmitters explained above adequately explain the symptoms of the case study and how they can be remedied. Pat has cases that need both excitatory and inhibitory neurotransmitters towards her care and well-being, she has extreme cases of anger and agitation that need to be evened out and at the same time needs to be mobile and alert thus the need for a neurotransmitter that will raise her nervous system.
How might you explain to them what might be going on based on the case information and your responses above?
As a caregiver, my observation from Pat?s previous treatment is that she has been misdiagnosed.Psychopharmacology: Case-Study Sample Paper The prescribed anti-psychotics, anti-depressants, and hypnotics have not improved her health. As a healthcare worker, I would recommend she uses acetylcholinesterase inhibitor (Aricept), this is a prescription that enhances memory and attention. These inhibitors act pharmacologically by increasing the level and duration of activity by the neurotransmitter, they achieve this by inhibiting the cholinesterase enzyme from breaking down
I would encourage Pat?s family to engage her in conversation instead of isolating her; this would help with her care and recovery. Flexibility in their schedules should be encouraged to reduce agitation Since she spends most of her time in a private room, I would encourage they visit her more often so she can have a company of people she is acquainted with instead of strangers (Taylor, Bouldin& McGuire, 2018).
As a health worker, I would advise Pat?s family to establish a safe environment to ease her mobility. Pat?s mobility has declined significantly, therefore to promote safety they will have to do away with clutter around the house now that she is using a wheelchair due to a series of falls. Install locks on any furniture that carries anything that is potentially harmful; this may include firearms, detergent, tools, and dangerous kitchenware (Creavin et al. 2016).
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In addition, the caregiver has to put fire safety measures in place to keep any fire lighting equipment out of reach; if the patient smokes as Pat does, they have to be supervised. It is also important to put the fire extinguisher in a place they can easily access From a health workers? perspective, I would ask Pat?s family to minimize frustration by not expecting her to do the things she used to do, much as she used to sing in a band her hearing is degenerating; that should be a reason for them to go slow on her. They should continue to make a connection with her like they are doing through singing but as a patient; she should be given frequent breaks and will need chores to be scheduled in a way that will not make her hurry. (McCormick et al. 2018).Psychopharmacology: Case-Study Sample Paper
Reference
Blanchard, A., Guégnard, F., Charvet, C. L., Crisford, A., Courtot, E., Sauvé, C., ?& Reaves, B. (2018). Deciphering the molecular determinants of cholinergic anthelmintic sensitivity in nematodes: When novel functional validation approaches highlight major differences between the model Caenorhabditis elegans and parasitic species. PLoS pathogens, 14(5), e1006996.
Creavin, S. T., Cullum, S. J., Haworth, J., Wye, L., Bayer, A., Fish, M., ?& Ben-Shlomo, Y. (2016). Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol. BMC family practice, 17(1), 79.
Figueiredo, D., Gabriel, R., Jácome, C., Cruz, J., & Marques, A. (2014). Caring for relatives with chronic obstructive pulmonary disease: how does the disease severity impact on family carers?. Aging & mental health, 18(3), 385-393.
Li, X., Yu, B., Sun, Q., Zhang, Y., Ren, M., Zhang, X., ?& Zeng, H. (2018). Generation of a whole-brain atlas for the cholinergic system and mesoscopic projectome analysis of basal forebrain cholinergic neurons. Proceedings of the National Academy of Sciences, 115(2), 415-420.
Iyer, K., Dilipkumar, N., Vasaya, S., Pawar, S., &Diwan, A. (2018). Comparison of Drug Related Problems Associated with Use of Narrow Therapeutic Index Drugs and Other Drugs in Hospitalized Patients. Journal of Young Pharmacists, 10(3), 318.
McCormick, A. J., Becker, M. J., & Grabowski, T. J. (2018).Involving People with Memory Loss in the Development of a Patient Handbook: A Strengths-Based Approach. Social work, 63(4), 357-366.Psychopharmacology: Case-Study Sample Paper
Nissen, N. I., Anderson, K. R., Wang, H., Lee, H. S., Garrison, C., Eichelberger, S. A., ? & Miwa, J. M. (2018). Augmenting the antinociceptive effects of nicotinic acetylcholine receptor activity through lynx1 modulation. PloS one, 13(7), e0199643.
Perry, S. M. (2018). Effect of Norepinephrine on Intracellular Ca 2 Levels in Malignant Hyperthermia-Susceptible B Cells: Pilot Study in the Search for a New Diagnostic Test for Malignant Hyperthermia. AANA Journal, 86(5).
Taylor, C. A., Bouldin, E. D., & McGuire, L. C. (2018).Subjective cognitive decline among adults aged= 45 years?United States, 2015?2016. Morbidity and Mortality Weekly Report, 67(27), 753.
Psychopharmacology ? Case-study Psychopharmacology: Case-Study Sample Paper
