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SafeAssign Originality Report • Submitted on Sun, Jan 28, 2024, 4:48 PM

Week 3 Medication Paper Psychopharmacology for Advanced Practice Nursing-HFX-DL01 Tashara R Jean

Total Score: 32 % Medium riskHeriberto Suarez Verdecia Submission UUID: e7837788-b4e5-5882-825a-6df1867dc54b

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Sertraline

Heriberto Suarez Verdecia

Florida National University

Psychopharmacology for Advanced Practice Nursing-DFX-DL01

Dr. Tashara R Jean

January 27, 2024

Antidepressants are prescription treatments to manage depression. This is a condition where one feels under the weather for a number of days. It is a common condition which impacts one’s mood as well as the general mental health. It makes one feel fatigued, worried as well as fearful. It changes one’s thinking, sleeping as well as eating. The condition as well causes people to think of committing suicide. Antidepressants improve the way the brain makes use of specific chemicals which manages mood as well as stress (Corponi, et al., 2020). Sertraline HCL is one of the commonly used antidepressants which are commonly used to manage mental or mood disorders. Evidence Based Treatment Selection

Sertraline is a treatment that manages the major depressive disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder,

premenstrual dysphoric disorder as well as social anxiety disorder. It boosts the levels of natural substance known as serotonin in the brain. Off label uses

The common off label uses of sertraline include the prevention of premature ejaculations given that it delays ejaculation. It is as well used for diabetic neuropathy

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since it increases production of insulin in the pancreas. Sertraline is also effective in preventing recurrent neurocardiogenic syncope in patients with intolerant to other therapies. Sertraline is as well used to manage fibromyalgia since it maximizes the brain’s serotonin levels which aid in minimizing symptoms related to depression and anxiety. Contraindications Sertraline is however not suitable for each person and thus there’re situations in which it should be avoided. People that have an allergy or sensitivity to sertraline should avoid this medication. In addition, sertraline should be avoided within 14 days of discontinuing medication the contains monoamine oxidase inhibitor. This can result to a life-threatening condition (Corponi, et al., 2020). The use of the medication during pregnancy and when breastfeeding should be cautiously considered and its potential pros and cons. The medication is released into the breast milk. Metabolism of sertraline takes place in the liver and thus people suffering from liver impairment require adjustments on the dose or other alternative medications. Mechanism of

Action

Sertraline inhibits the reuptake of serotonin at the presynaptic neuronal membrane and thus maximizing serotonergic operations. This leads to high

synaptic concentration of serotonin in the CNS, which results to various functional transitions related to enhanced serotonergic neurotransmission. They are result to antidepressant action as well as the impacts of obsessive-compulsive. Chronic use of sertraline leads to down-regulation of brain norepinephrine receptors. Sertraline has an affinity for signma-1 and 2 receptor binding sites but connects with greater affinity to sigma-1 connecting sites. With vitro,

sertraline has minimal or no affinity for GABA, dopaminergic, serotonergic or benzodiazepine receptors. It puts weak inhibitory actions on the neuronal uptake on norepinephrine as well as dopamine and shows no inhibitory impacts on the monoamine oxidase enzyme (Huddart, et al., 2020). Side Effects

Sertraline operates well but still has side effects. The most common side effect of sertraline is nausea. About 1 in 4 individuals that are taking the medication

experience it. It mostly take place when one begins taking the medication or just after a dose increase. Nausea usually improves with time as the body adjusts to the treatment. Diarrhea is as well a common side effect of sertraline. It however improves within a few weeks. If diarrhea persists, the patients are

recommended to notify the medical provider for them to recommend another antidepressant. About 15% of the individuals taking sertraline experience dry mouth. This can be managed through the intake of cold water throughout the day and consumption of sugar free gum. Sertraline as well results to sexual side effects (Corponi, et al., 2020). The patient may experience ejaculation problems, low sex drive, and erectile dysfunction. These side effects do not improve with time. Some people taking the medication may experience increase of weight while others may experience weight loss. Serotonin syndrome is a fatal side effect which can occur when there’s excess of serotonin in the brain. This occurs when the medication is mixed with other treatments. This condition may lead to confusion, high blood pressure as well as uncontrolled body movements. Lab Monitoring/ Follow up

Health care givers should ensure that the medication is effective and addresses the side effects. There are several follow ups needed for sertraline. One should always watch out for the signs of neuroleptic malignant syndrome which include hyperthermia, diaphoresis, muscle rigidity, poor mental status, tachycardia, change in hypertension and incontinence (Luciano, et al., 2023). Health care givers should as well offer education to the patient about the treatment which includes the side effects and the need for compliance with the prescribed regimen. One should as well create a follow-up schedule in regard to the patients’ needs as well as clinical situations. Role of the Psychiatric Mental Health Nurse Practitioner in the role of prescribing and managing sertraline

Psychiatric Mental Health Nurse Practitioners plays a major role in prescribing and managing treatments. The practitioners conduct a detailed psychiatric assessment to identify the patient’s mental health state which will help them identify a diagnosis. They then prescribe the medication and assess or change treatment for patients. They assess the effectiveness of the treatment in regard to the patient’s diagnosis, symptoms, medical history and the potential contraindications (Davis & Buscemi, 2023). Offer education to patients and their caregivers on the medication and highlight the need for medication and deal with any challenges. Carry out follow ups to identify to the patient’s response to the medication and adjust the treatment if required.

References

Corponi, F., Fabbri, C., & Serretti, A. (2020). Antidepressants: indications, contraindications, interactions, and side effects. NeuroPsychopharmacotherapy, 1-38. https://doi.org/10.1007/978-3-319-56015-1_29-1

Davis, A., & Buscemi, C. (2023). Improving Psychiatric Mental Health Nurse Practitioners’ Knowledge of Cognitive Behavioral Therapy and Benzodiazepines for the Treatment of Mild to Moderate Generalized Anxiety Disorder: A Quality Improvement Project. Nicole Wertheim College of Nursing Student Projects. https://digitalcommons.fiu.edu/cnhs-studentprojects/177

Huddart, R., Hicks, J. K., Ramsey, L. B., Strawn, J. R., Smith, D. M., Babilonia, M. B., & Klein, T. E. (2020). PharmGKB summary: sertraline pathway,

pharmacokinetics. Pharmacogenetics and genomics, 30(2), 26. https://doi.org/10.1097%2FFPC.0000000000000392

Luciano, M. T., Norman, S. B., Allard, C. B., Acierno, R., Simon, N. M., Szuhany, K. L., & PROGrESS Study Team. (2023). The influence of posttraumatic

stress disorder treatment on anxiety sensitivity: Impact of prolonged exposure, sertraline, and their combination. Journal of Traumatic Stress, 36(1), 157-

166. https://doi.org/10.1002/jts.22894

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Florida National University Psychopharmacology for Advanced Practice Nursing-DFX-DL01

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Florida National University Psychopharmacology for Advanced Practice Nursing (DFX-DL01)

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Tashara R Jean

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Tashara R Jean

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Evidence Based Treatment Selection

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Evidence-Based Treatment Selection (FDA-Approved Uses)

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Sertraline is a treatment that manages the major depressive disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder as well as social anxiety disorder.

Original source

Sertraline has been approved for major depressive disorder (MDD), obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder (SAD)

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Off label uses

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Off-Label Uses

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Mechanism of Action

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Mechanism of Action

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Sertraline inhibits the reuptake of serotonin at the presynaptic neuronal membrane and thus maximizing serotonergic operations.

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Sertraline (Zoloft) selectively inhibits presynaptic serotonin reuptake at the neuronal membrane

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This leads to high synaptic concentration of serotonin in the CNS, which results to various functional transitions related to enhanced serotonergic neurotransmission.

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This results in an increased synaptic concentration of serotonin in the CNS, which leads to numerous functional changes associated with enhanced serotonerg

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With vitro, sertraline has minimal or no affinity for GABA, dopaminergic, serotonergic or benzodiazepine receptors.

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In vitro studies demonstrate no significant affinity for adrenergic, cholinergic, GABA, dopaminergic, histaminergic, serotonergic, or benzodiazepine receptors” (“Sertraline

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The most common side effect of sertraline is nausea.

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Diarrhea Diarrhea is a common side effect of sertraline

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Diarrhea is as well a common side effect of sertraline.

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Diarrhea Diarrhea is a common side effect of sertraline

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Lab Monitoring/ Follow up

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Lab Monitoring/Follow-Up

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Role of the Psychiatric Mental Health Nurse Practitioner in the role of prescribing and managing sertraline Psychiatric Mental Health Nurse Practitioners plays a major role in prescribing and managing treatments.

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Role of the Psychiatric Mental Health Nurse Practitioner in the Role of Prescribing and Managing the Medication Role of the Psychiatric Mental Health Nurse Practitioner in the Role of Prescribing and Managing the Medication

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https://doi.org/10.1007/978-3-319-56015-1_29-1

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doi:10.1007/978-3-319-12538-1_16

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K., Ramsey, L.

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R., & Ramsey, L

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https://doi.org/10.1097%2FFPC.0000000000000392

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T., Norman, S. B., Allard, C. B., Acierno, R., Simon, N. M., Szuhany, K.

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T., Norman, S B., Allard, C B., Acierno, R., Simon, N M., Szuhany, K

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The influence of posttraumatic stress disorder treatment on anxiety sensitivity: Impact of prolonged exposure, sertraline, and their combination.

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The influence of posttraumatic stress disorder treatment on anxiety sensitivity Impact of prolonged exposure, sertraline, and their combination

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Student paper 100 %

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Journal of Traumatic Stress, 36(1), 157-166.

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Journal of Traumatic Stress, 36(1), 157–166

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https://doi.org/10.1002/jts.22894

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https://doi.org/10.1002/jts.22894