Pharmacological Management of Major Depression in Older Adults Using Essay

Pharmacological Management of Major Depression in Older Adults Using Selective Serotonin-Reuptakes Inhibitors - Essay Example They have minimal effect on noradrenalin and dopamine activity, compared to the tricyclics or MAOIs. Some of the drugs, like fluoxetine, have a mood elevating effect when used in healthy individuals. Fluoxetine drug has the longest half-life amongst all approved SSRIs with drug and side effects persisting up to six weeks after the termination of therapy. Introduction Serotonin is an important neurotransmitter, a local hormone in the gut, a component of the platelet clotting process, and is thought to play a role in migraine headache. Serotonin is also one of the mediators of the signs and symptoms of carcinoid syndrome, an usual manifestation of carcinoid tumor, a neoplasm of enterochromaffin cells. Patients with non-operable tumor, take serotonin antagonist for a useful treatment. The diagnosis of depression still rests primarily on the clinical interview. Major depressive disorder (MDD) is characterized by depressed mood most of the time for at least 2 weeks and/ or loss of interes t or pleasure in most activities. Additionally, depression is associated with sleep, as well as diet disturbances and deficits in cognition and energy. Thoughts of guild, worthlessness and suicide are common. Coronary artery disease, diabetes and stroke appear to be more common in depressed patients and depression may considerably worsen the prognosis for patients with a variety of comorbid medical conditions (Katzang, 2009; Rang, 2009; Kaushik, 2011). Reports by Centers for Disease Control and Prevention highlight the fact that antidepressant drugs were the most commonly prescribed medications in the USA. It is observed that American physicians have been increasingly inclined to use antidepressants to treat a host of conditions that patients have been increasingly receptive to their use. Major depression is commonly associated with a variety of medical conditions from chronic pain to coronary artery disease, panic disorder, generalized anxiety disorder (GAD), post traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) specifically in older individuals or other related old age diseases which enhances the burden of depressive thoughts and also affects the quality or life. All these reasons paved the way for growth in the use of antidepressants ( Katzang, 2009; Rang, 2009). Comparison of SSRIs with Tricyclic Antidepressants (TCAs) - The first line of antidepressant treatment suggested for elderly population involves SSRIs (Selective Serotonin Reuptake Inhibitors). There are weak facts for this suggestion as studies carried out highlight the comparative usefulness, protection, acceptability, as well as success of SSRIs and TCAs suggesting that there are a few optional returns of both these drugs over one another. Moreover, there is always a potential danger of falls which is prevalent in elderly patients, hyponatremia, loss of weight and sexual dysfunction, as well as drug-drug interactions. Therefore, SSRIs and TCAs must be prescribed by physician s for elderly patients considering frequency and severity of depression (Herrmann, 2000). Pathophysiology of Major Depression Observations reveal that there is a tremendous shift that has been witnessed for understanding the pathophysiology of major depression. Initially, the amount of monoamines was considered to be the central to the biology of depression. Evidence suggests that neurotrophic and endocrine factors

Purchasing Development Assignment Example | Topics and Well Written Essays - 1500 words

Purchasing Development - Assignment Example For instance, a general purpose purchasing system might procure materials the way we want it to but doesn’t give us a receipt of each individual transaction (assuming we need receipts for each and every transaction). Design systems on the other hand are specifically designed from business to business and provide all functionalities that are needed for a successful purchasing function. It is necessary that procurement systems be integrated in all processes and departments of an organization. This would save the organization a lot of time and money as whenever anyone would require something, all he needs to do is send a procurement request to the purchasing department rather than waiting for the purchasing department to figure out for itself when inventory count goes down and wait for them to reorder. Sometimes there might be commercial issues arising as a result of change in organizational business plans. For instance our organization might aim to cut down on its costs as a way to maximize profits. It might plan to do so by purchasing raw materials and other supplies at a lower cost than usual. The procurement system here would need to consider whether switching suppliers to one offering a lower cost would still mean that the supplies are of the same quality. It would also need to consider whether the supplier would be able to deliver on time and not back out at the very last moment and leave us doomed. Such decisions need to be taken by the procurement department bearing the risk that a risk that a new supplier might default at any time! James (2009) in his book Buying Complex Systems stresses how it is very necessary to properly define the objectives of the purchasing operations and make sure they support the strategic objectives of the company as a whole. For instance if an organization aims to differentiate its product by offering high quality products and on the other hand the purchasing operation aims to save on money and therefore purchases low qua lity raw material then then definitely the overall aim of delivering high quality products won’t be met. The objectives of the purchasing operations need to be in line with the organization’s strategy if the organization wants to prosper. Evaluate the current and future effectiveness of an identified purchasing operational system I’m going to discuss the purchase operational system of the Agha’s Supermarket. The mart is located in the posh locality of Clifton and caters to thousands of people on a daily basis. The store is divided into many sections like crockery and cutlery, food items, vegetables etc. The purchase manager is responsible for making purchases on an overall basis. The purchase manager has a team of people, each of whom is sent out by him to different sections of the market to see the stock requirements. The team surveys the section heads every second day and pens down the stock requirement on a piece of paper. The entire team meets the pur chase operations manager the next and report to him about the stock requirement. The purchasing manager then places purchase orders and goods are obtained by the company the very next day. The current system isn’t ideal enough to deal with unexpected demand fluctuations. Miscalculations might be made by section heads while ordering stock and in the meanwhile stock outs may be experienced leading to nil sales and loss of