Nursing: Impact of Ethnicity
Nursing: Impact of Ethnicity
Week 3 discussion
Discussion: The Impact of Ethnicity on Antidepressant Therapy
Major depressive disorder is one of the most prevalent disorders you will see in clinical practice Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture
Learning Objectives
Students will:
Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy
Analyze the impact of ethnicity on antidepressant therapy
Evaluate efficacy of treatment plans
Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapy
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link This link will take you to a log-in page for the Walden Library Once you log into the library, the Stahl website will appear
Stahl, S M (2013) Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed) New York, NY: Cambridge University Press
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter Be sure to read all sections on the left navigation bar for each chapter
Chapter 7, “Antidepressants”
Stahl, S M (2014b) The prescriber’s guide (5th ed) New York, NY: Cambridge University Press
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication
Review the following medications:
amitriptyline
bupropion
citalopram
clomipramine
desipramine
desvenlafaxine
doxepin
duloxetine
escitalopram
fluoxetine
fluvoxamine
imipramine
ketamine
mirtazapine
nortriptyline
paroxetine
selegiline
sertraline
trazodone
venlafaxine
vilazodone
vortioxetine
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th ed) Washington, DC: Author
Note: Retrieved from Walden Library databases
Howland, R H (2008a) Sequenced treatment alternatives to relieve depression (STAR*D) Part 1: Study design Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24 doi:103928/02793695-20080901-06
Note: Retrieved from Walden Library databases
Howland, R H (2008a) Sequenced treatment alternatives to relieve depression (STAR*D) Part 2: Study outcomes Journal of Psychosocial Nursing and Mental Health Services, 46(19), 21–24 doi:103928/02793695-20081001-05
Note: Retrieved from Walden Library databases
Yasuda, SU, Zhang, L & Huang, S-M (2008) The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies Clinical Pharmacology & Therapeutics, 84(3), 417–423 Retrieved from https://webarchiveorg/web/20170809004704/https://wwwfdagov/downloads/Drugs/ScienceResearch//UCM085502pdf
To prepare for this Discussion:
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number
Case 1: Volume 1, Case #1: The man whose antidepressants stopped working
Case 2: Volume 1, Case #7: The case of physician do not heal thyself
Case 3: Volume 1, Case #29: The depressed man who thought he was out of options
Review this week’s Learning Resources and reflect on the insights they provide
Go to the Stahl Online website and examine the case study you were assigned
Take the pretest for the case study
Review the patient intake documentation, psychiatric history, patient file, medication history, etc As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (ie, family members, teachers, nursing home aides, etc)
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient
Develop a differential diagnoses for the patient Refer to the DSM-5 in this week’s Learning Resources for guidance
Review the patient’s past and current medications Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient
Review the posttest for the case study