NR 508 week 4 part 3 discussion

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Discussion Part Three You decide to begin the patient on bupropion.  At what dose should she be started on bupropion, and how does bupropion differ from other commonly prescribed antidepressants... , such as fluoxetine, venlafaxine, and nortriptyline?  Why would this be the best option for this patient given her symptoms and lifestyle? In your answer, be sure to compare and contrast bupropion with each medication mentioned above (fluoxetine, venlafaxine, and nortriptyline). Subjective 39 year old female with adhedonia and depressed mood the past several months Objective Pertinent positives – Barbara is a married female, smokes 1 pack/day, experiencing fatigue, feelings of worthlessness, appetite disturbances, weight gain, lack of concentration, insomnia, and psychomotor disturbances. Weight 180lbs (overweight, possibly obese) height needed Anhedonia – lack of interest or pleasure in normal activities Pertinent negatives – no children, has not needed therapy for 20 years Pertinent + in RED Pertinent – in BLUE Assessment Major Depression Disorder Current Plan Bupropion 100 mg PO BID for 3 days, may increase to 100 mg PO TID; MAX dose is 450 mg/day given as 150 mg PO TID OR 100 mg PO 4 times daily; separate all doses by at least 6 hours; MAX single dose is 150 mg (DynaMed Plus, 2016). Mechanism of Action - this aminoketone class antidepressant blocks neuronal uptake of dopamine. This medication has no effect on monoamine oxidase or serotonin uptake. Smoking cessation properties are believed to be associated with dopaminergic action of bupropion (DynaMed Plus, 2016). Clinical Use - depression, seasonal affective disorders, major depression, and smoking cessation assistance (initial treatment while still smoking). Efficacy - improvement in signs [Show More]

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