Author Question: A patient is diagnosed with major depression with severe symptoms and begins taking an ... (Read 39 times)

natalie2426 · **on:** Jul 23, 2018

A patient is diagnosed with major depression with severe symptoms and begins taking an antidepressant medication. Three weeks after beginning therapy, the patient tells the nurse that the drug is not working.

The nurse will counsel this patient to ask the provider about: a. adding a second medication to comple-ment this drug.
b. changing the medication to one in a dif-ferent drug class.
c. increasing the dose of this medication.
d. using nondrug therapies to augment the medication.

Question 2

A patient asks a nurse to explain what drug tolerance means. The nurse responds by telling the patient that when tolerance occurs, it means the patient:

a. has developed a psychologic dependence on the drug.
b. may need increased amounts of the drug over time.
c. will cause an abstinence syndrome if the drug is discontinued abruptly.
d. will have increased sensitivity to drug side effects.

pallen55 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

D
Patients with severe depression benefit more from a combination of drug therapy and psycho-therapy than from either component alone, so this patient should ask the provider about nondrug therapies. Once a drug has been selected for treatment, it must be used for 4 to 8 weeks before its efficacy can be assessed. Until a drug has been used at least 1 month without success, it should not be considered a failure. Adding a second medication, changing to a different medication, and increasing the dose of this medication should all be reserved until the current drug is deemed to have failed after at least 4 weeks.

Answer to Question 2

B
When tolerance develops, a dose increase may be needed, because a decreased response may occur with prolonged use. Psychologic dependence involves cravings for drug effects and does not define tolerance. Physical dependence occurs when the drug becomes necessary for the brain to function normally, meaning the patient should be weaned from the drug slowly to prevent an abstinence syndrome. Patients may have a decreased sensitivity to drug side effects over time as the brain adapts to the medication.