WEEK 4 ASSIGNMENT

USING THIS ARTICLE COMPLETE THE FOLLOWING STEPS.

WHICH ARE

MODULE 3 PART 3 STEP

1

(T

ABLE)

AND STEP 2

(PARAGRAPH)

Title:

Update

on

Neurodegenerative

Diseases

and

Glutamate:

A

PMHNP

Single

Case

Study

Report

of

a

Diagnostically

Complex

Adult

Patient,

Interventions,

and

Unexpected

Outcomes.

Authors:

Kroll

SC;

Sherri

Cofield

Kroll,

MSN,

APRN,

FNP

-

BC,

PMHNP

-

BC,

CARN

-

AP,

Outpatien

t

Private

Practice

PMHNP,

Deuser

&

Associates,

PC,

Brunswick,

GA,

USA.

Bennett

CF;

Carole

Frances

Bennett,

PhD,

APRN,

PMHCS

-

BC,

Georgia

Southern

University,

Statesboro,

GA,

USA.

Klinefelter

TW;

Tarah

Winter

Klinefelter,

MSN,

APRN,

PMHNP

-

BC,

Psychiatric

Men

tal

Health

Nurse

Practitioner

in

Geriatric

Psychiatry,

El

Paso,

TX,

USA.

Source:

Journal

of

the

American

Psychiatric

Nurses

Association

[J

Am

Psychiatr

Nurses

Assoc]

2021

Jul

08,

pp.

10783903211030343.

Date

of

Electronic

Publication:

2021

Jul

08.

Objective:

While

dysfunction

of

serotonin

and

dopamine

neurotransmitters

has

been

studied

in

depth,

in

regard

to

the

etiology

of

mental

illness,

the

neurotransmitter

glutamate

and

its

dysfunction

is

now

being

explored

as

contributing

to

neurodegenerative

psychiatric

diseases,

schizophrenia,

autism,

depression,

and

Alzheimer's

disease.

This

article

explains

its

synthesis,

neurotransmission,

and

metabolism

within

the

brain

and

subsequent

dysfunction

th

at

is

responsible

for

neurocognitive

loss

associated

with

several

psychiatric

disorders.

Method:

The

case

study

will

report

on

the

screening

for

pseudobulbar

affective

(PBA)

disorder

in

a

29

-

year

-

old

male

with

bipolar

disorder,

autism

spectrum

disorder,

an

d

intellectual

developmental

disability

who

was

experiencing

extreme,

uncontrolled

emotional

outbursts

requiring

continuous

family

isolation

(pre

-

COVID

-

19)

for

safety.

With

the

positive

screen

for

PBA,

the

patient

was

subsequently

treated

with

a

glutamater

gic

drug,

dextromethorphan/quinidine.

Results:

The

patient's

unexpected

response

to

this

treatment

including

the

acquisition

of

language,

increased

cognition,

and

improved

executive

functioning

is

presented.

At

2

years

post

the

initiation

of

treatment,

his

PBA

screening

score

is

reduced,

uncontrolled

outbursts

and

aggression

have

subsided,

and

the

family

can

spend

time

outside

of

their

home.

Conclusions:

Neurodegeneration

and

its

impact

is

being

researched

and

treated

with

medications

affecting

glutamate.

T

he

addition

of

a

glutamatergic

medication

to

this

young

man's

medication

regimen

has

improved

both

his

and

his

family's

quality

of

life.

The

psychiatric

diagnoses,

medications,

and

treatments

associated

with

glutamate

are

explained

in

depth.

The

importance

of

nurses'

understanding

of

glutamate,

its

synthesis,

transmission,

and

dysfunction

causing

excitotoxicity

and

brain

cell

death

and

its

impact

on

patients'

behavior

and

safety

is

explained.

Contributed

Indexing:

Keywords:

glutamatergic

dysfunction;

neuroc

ognitive

degeneration;

severe

chronic

psychiatric

illness

Entry

Date(s):

Date

Created:

20210709

Latest

Revision:

20210709

Update

Code:

20220301

DOI:

10.1177/10783903211030343

PMID:

34238041

Persistent

link

to

this

record

(Permalink):

https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=m

nh&AN=34238041&s

ite=eds

-

live&scope=site&custid=s6527200

Cut

and

Paste:

<A

href="https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mnh&AN=34238

041&site=eds

-

live&scope=site&custid=s6527200">Update

on

Neurodegenerative

Diseases

and

USING THIS ARTICLE COMPLETE THE FOLLOWING STEPS. WHICH ARE MODULE 3 PART 3 STEP 1(TABLE)

AND STEP 2 (PARAGRAPH)

Title:

Update on Neurodegenerative Diseases and Glutamate: A PMHNP Single Case Study Report of

a Diagnostically Complex Adult Patient, Interventions, and Unexpected Outcomes.

Authors:

Kroll SC; Sherri Cofield Kroll, MSN, APRN, FNP-BC, PMHNP-BC, CARN-AP, Outpatient Private

Practice PMHNP, Deuser & Associates, PC, Brunswick, GA, USA.

Bennett CF; Carole Frances Bennett, PhD, APRN, PMHCS-BC, Georgia Southern University,

Statesboro, GA, USA.

Klinefelter TW; Tarah Winter Klinefelter, MSN, APRN, PMHNP-BC, Psychiatric Mental Health

Nurse Practitioner in Geriatric Psychiatry, El Paso, TX, USA.

Source:

Journal of the American Psychiatric Nurses Association [J Am Psychiatr Nurses Assoc] 2021 Jul

08, pp. 10783903211030343. Date of Electronic Publication: 2021 Jul 08.

Objective: While dysfunction of serotonin and dopamine neurotransmitters has been studied in

depth, in regard to the etiology of mental illness, the neurotransmitter glutamate and its

dysfunction is now being explored as contributing to neurodegenerative psychiatric diseases,

schizophrenia, autism, depression, and Alzheimer's disease. This article explains its synthesis,

neurotransmission, and metabolism within the brain and subsequent dysfunction that is

responsible for neurocognitive loss associated with several psychiatric disorders.

Method: The case study will report on the screening for pseudobulbar affective (PBA) disorder in

a 29-year-old male with bipolar disorder, autism spectrum disorder, and intellectual

developmental disability who was experiencing extreme, uncontrolled emotional outbursts

requiring continuous family isolation (pre-COVID-19) for safety. With the positive screen for PBA,

the patient was subsequently treated with a glutamatergic drug, dextromethorphan/quinidine.

Results: The patient's unexpected response to this treatment including the acquisition of

language, increased cognition, and improved executive functioning is presented. At 2 years post

the initiation of treatment, his PBA screening score is reduced, uncontrolled outbursts and

aggression have subsided, and the family can spend time outside of their home.

Conclusions: Neurodegeneration and its impact is being researched and treated with

medications affecting glutamate. The addition of a glutamatergic medication to this young man's

medication regimen has improved both his and his family's quality of life. The psychiatric

diagnoses, medications, and treatments associated with glutamate are explained in depth. The

importance of nurses' understanding of glutamate, its synthesis, transmission, and dysfunction

causing excitotoxicity and brain cell death and its impact on patients' behavior and safety is

explained.

Contributed Indexing:

Keywords: glutamatergic dysfunction; neurocognitive degeneration; severe chronic psychiatric

illness

Entry Date(s):

Date Created: 20210709 Latest Revision: 20210709

Update Code:

20220301

DOI:

10.1177/10783903211030343

PMID:

34238041

Persistent link to this record (Permalink):

https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mnh&AN=34238041&s

ite=eds-live&scope=site&custid=s6527200

Cut and Paste:

<A

href="https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mnh&AN=34238

041&site=eds-live&scope=site&custid=s6527200">Update on Neurodegenerative Diseases and