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Explain the benefits of pharmacogenomic testing. Regardless of your personal opinion, take the “pro” side of the argument and find evidence to support why more clinicians should be using this in their practice.
Pharmacogenomics is the study of pharmacy and genes considered to provide a guide for drug prescribing and considered a means to improving and providing guidance for drug prescribing (Sink & Scardina, 2020). It is recommended that providers should be using genetic testing in their practice because genetic testing allows us to learn how the genes in DNA an individual inherited from their parents might affect their health (Sink & Scardina, 2020). Pharmacogenetic testing refers to testing the genetic makeup to see how their body processes different medications (Sink & Scardina, 2020). The focus is identifying genetic variations that influence how drugs may be absorbed and metabolized in the body (Sink & Scardina, 2020). Pharmacogenetic testing helps patients and providers learn how effectively and how quickly a person’s body metabolizes and process certain medications.
Genetic testing is a great thing because it assists both in the diagnosing psychiatric illnesses and in selecting psychotropic medications (Stahl, 2013). The patient’s cheek is swabbed or blood is drawn and sent to a lab to process the pharmacogenetic information. I think this testing is a go and very beneficial when patients have tried several medications for a mental illness and nothing has worked effectively enough. The test results will allow the provider to make decisions about what meds to prescribe that works best with the patient’s genetic makeup, along with sorting out past medications side effects as well as risk and benefits regarding past medication therapy (Sink & Scardina, 2020).
Most of this testing is done for adults not children. Genetic testing is a great benefit to the patient as well as the provider. Choosing a medication that provides a good outcome for children can be very difficult because children really have no way of describing how they feel therefore medication therapy can be very tricky (Schuck et al., 2016). Accreditation schools for advanced practice nurse education are adding genomics competencies within graduate school programs. Advanced practice nurse roles who provide drug therapy for patients need to have an understanding that if patients do not respond or have a slow response to standard treatment, pharmacogenetic testing can help generate a positive outcome for the patients by helping to understand which medications work best for their genotype.
I think pharmacogenomic testing is a must and very important when prescribing medications to a mentally disturbed patient. As providers we need to understand how a particular medication works in the body. Pharmacogenomics can predict the responses and as stated above and give the provider guidance as to which drug would be beneficial and safe.
Discuss special considerations associated with the psychiatric interview of children.
It is important to realize a disorder within childhood can having lasting effects on life beyond a psychiatric issue, these disorders may lead to social, cognitive, and psychologic delay (Duclan, et al., 2018). It also also important to make the accomdations to gather information about the patient from different sources such as parents and school, as a child rarely initiates a psychoatric evaluation (Boland & Verduin, 2022). Children tend to struggle with explaining when symptoms begin or what triggers them, however they tend to be able to express the feelings well and in detail (Bonland & Verduin, 2022). When conducting an interview, it is important to be aware of childs comfort level or their set boundaries, for example, if a child has severe seperation anxiety from their parent, it may not be in the best interest to sepeare the two at their first appointment (Boland & Verduin. 2022).
It is also important to realize appropriate behavior, what is appropriate for a 2 year old behavior is different than what is appropriate for a 12 year old, a child should feel comfortable to display appropriate outburst and be able to express their feelings in a clinical setting (Boland & Verduin, 2022). It is also important to remember different interview based tools to further help a patient explain symptoms, the most common for a young child would be the pictorial based interview (Boland & Verduin, 2022).
It is important to determine which types of assessments may be needed for a pediatric patient these may include neuropsychiatric assessments, ADHD assessments, and developmental testing (Boland & Verduin, 2022). It is also important to realize what disorders in children have what types of sensitivies, children are more prone to not voicing discomfort, so it is important to realize we need to avoid certain triggers that may be present (Boland & Verduin, 2022).
In conclusion, a child psychiatric interview involves way more than 1 person or 1 approach. A provider must recognize parents concerns and adapt to a childs needs. Children also must be granted the developmental level they should be on, a provider will have to continously adapt their interview process in order to get an optimal outcome for the patient.