Pharmacology-Primary Care Medication Management
A patient is being seen at your clinic for depression and has been prescribed Zoloft. At today’s visit, she admitted to still taking St. John’s Wort. What do you tell her?
The patient should immediately stop using St. John’s Wort while on Zoloft. Though strong scientific evidence has pointed out that St. John’s wort has high efficacy rates in the treatment and management of mild to moderate depression, these pieces of evidence have also indicated that it may be accompanied by adverse interaction with other medications, specifically antidepressant drugs (Rahman & Münch, 2018). When used alongside Zoloft, St. John’s wort significantly elevates the level of serotonin, thereby causing cardiovascular problems, including angina, hypertension, myocardial infarction (heart failure), and tachycardia (irregular heartbeats). Do you need urgent assignment help ? Our homework help will you tons of energy and time required for your homework papers.
A patient asks if they would benefit from taking Aricept for their mild dementia. What is your response?
Aricept is an effective treatment for confusion (mild dementia) arising from Alzheimer’s disease. Although it does not entirely cure Alzheimer’s, it enhances awareness, memory, and other cognitive functions. Aricept functions by restoring the inherent balance of neurotransmitters within the brain (Birks & Harvey, 2018).
Your patient asks if they should take Propranolol at the beginning of a migraine headache. How do you respond?
The medication should be taken per the prescription instructions (TID) to avoid misuse, meaning it should not be administered only at the beginning of a migraine. While the pharmacology of Propanol is not well-known, it is believed that the medication aids in alleviating migraines by stabilizing the blood vessels in the brain and mitigating their dilation. Furthermore, the medication also decreases the excitability of the brain and enhances the anxiety of the patient, reducing the frequency and intensity of migraines (Linde & Rossnagel, 2017).
A patient requires treatment for his ADHD but is drug-tested at his job, and they have a zero-tolerance policy. Is there a medication he can take to help his attention and focus?
Methylphenidate: The medication is considered one of the most effective and widely tolerated treatments for attention deficit or hyperactivity disorder.
What is the most commonly used dopaminergic drug used for Parkinson’s?
Carbidopa-levodopa is an effective treatment. Levodopa is a natural chemical that passes directly into the brain and is converted to dopamine. Levodopa is integrated with carbidopa, which prevents levodopa from early conversion into dopamine while outside the brain, thereby reducing side effects such as nausea (Tambasco & Calabresi, 2018). The rationale for this treatment stems from the fact that all individuals who have Parkinson’s have lower concentrations of dopamine within their brains.
What other disorders are many of the Antiepileptic drugs used for? Name 2 of the drugs.
Anxiety: gabapentin and pregabalin
Migraine prophylaxis: topiramate and sodium valproate
References
Birks, J. S., & Harvey, R. J. (2018). Donepezil for dementia due to Alzheimer’s disease. The Cochrane database of systematic reviews, 6(6), CD001190. https://doi.org/10.1002/14651858.CD001190.pub3
Linde, K., & Rossnagel, K. (2017). Propranolol for migraine prevention. The Cochrane database of systematic reviews, 2(2), CD003225. https://doi.org/10.1002/14651858.CD003225.pub3
Rahman, S. Z., & Münch, G. (2018). Use of serotonergic antidepressants and St John’s wort in older Australians: a population-based cohort study. Australasian psychiatry: bulletin of Royal Australian and New Zealand College of Psychiatrists, 21(3), 262–266. https://doi.org/10.1177/1039856213475681
Tambasco, N. & Calabresi, P. (2018). Carbidopa-levodopa in Parkinson’s Disease: Current Status and Future Developments. Current neuropharmacology, 16(8), 1239–1252. https://doi.org/10.2174/1570159X15666170510143821
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Question 
Post your answers to the six questions corresponding to this week’s content on primary care medication management. Provide your responses and rationales. Support your explanations with high-level evidence. (See Post Expectations)
Pharmacology-Primary Care Medication Management
A patient is being seen at your clinic for depression and has been prescribed Zoloft. At today’s visit, she admitted to still taking St. John’s Wort. What do you tell her?
A patient asks if they would benefit from taking Aricept for their mild dementia. What is your response?
Your patient asks if they should take Propranolol at the beginning of a migraine headache. How do you respond?
A patient requires treatment for his ADHD but is drug-tested at his job, and they have a zero-tolerance policy. Is there a medication he can take to help his attention and focus?
What is the most commonly used dopaminergic drug used for Parkinson’s?
What other disorders are many of the Antiepileptic drugs used for? Name 2 of the drugs.
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