Prescribing for Older Adults and Pregnant Women

• To Prepare:

• Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5 to use.
• Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label” drug, and one nonpharmacological intervention for treating the disorder in that population.

By Day 3 of Week 9

• Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.
• Explain the risk assessment you would use to inform your treatment decision  making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
• Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
• Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.

Week 9: Special Considerations Related to Vulnerable Populations
The psychiatric mental health nurse practitioner assumes probably no greater responsibility than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications. It is of critical importance to understand the risks and benefits of the medications prescribed and their varying potential effects on special populations such as children/adolescents, pregnant women, or older adults.

This week, you examine the special considerations when prescribing for pregnant women and older adults.
Learning Objectives
Students will:

Recommend psychopharmacological and nonpharmacological interventions for older adults and pregnant women in mental health settings
Evaluate the risks and benefits of pharmacological treatment for older adults and pregnant women
Justify clinical decision making related to pharmacological treatment of older adults and pregnant women in mental health settings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

• Chapter 27, “Psychiatry and Reproductive Medicine”
• Chapter 33, “Geriatric Psychiatry” 

Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.

• Chapter 3, “Vulnerable Populations”
• Chapter 4, “Mental Health and Primary Care: A Critical Intersection”
• Chapter 5, “Cultural Sensitivity and Global Health”

Required Media (click to expand/reduce)American Psychiatric Association. (2020). Geriatric telepsychiatry [Video]. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry/toolkit/geriatric-telepsychiatry