PMHNP Prescribing fibro-fog
PMHNP Prescribing fibro-fog
PMHNP Prescription for fibro-fog
The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work?
a) It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels
b) It will induce synaptic changes, including sprouting
c) It will act on the presynaptic neuron to trigger sodium influx
d) It will Inhibit activity of dorsal horn neurons to suppress body input from reaching the brain
Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition?
a) Nenlafaxine (Effexor)
b) Armodafinil (Nuvigil)
c) Bupropion (Wellbutrin)
d) All of the above
The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain?
a) Methylphenidate (Ritalin)
b) Viloxazine (Vivalan)
c) Imipramine (Tofranil)
d) Bupropion (Wellbutrin)
The PMHNP is attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select?
a) Pregabalin (Lyrica)
b) Duloxetine (Cymbalta)
c) Modafinil (Provigil)
d) Atomoxetine (Strattera)
is a chronic rheumatic disorder. It affects an estimated 5 million Americans adults, reports the . Women account for up to 90 percent of those diagnosed with the condition.
Fibromyalgia causes pain and tenderness in your joints and soft tissues. Other common symptoms include memory and cognition problems. Many people use the words “brain fog” or “fibro fog” to describe these symptoms.
When you have fibro fog, it feels like you’re in a haze. You might experience one or more of the following:
- decreased alertness
- inability to concentrate or stay focused
Your symptoms can vary from mild to severe. You may find that they occasionally get better or worse. Overstimulation, stress, poor sleep, and certain medications may cause them to get worse.
“I am the Post-it Note Queen. It is the only way I was able to function at work, when I was able to function. It made my boss crazy. She couldn’t understand why I needed so many notes, and notes on notes, and a big one-month calendar in front of me with everything posted.
I just become overwhelmed by so many things. I need to remember [if I] did something, or just [thought I] did it. Lots of time for me is spent daydreaming about what I have to do when the pain is not too much. It’s small spurts of energy to get things done and then downtime lost in brain fog and exhaustion.”
—Diane P., 55 years old
To relieve fibro fog and other symptoms, follow your doctor’s recommended treatment plan. They may prescribe one or more medications. For example, the (FDA) has approved several drugs to treat fibromyalgia, including pregabalin (Lyrica), gabapentin (Neurontin), duloxetine (Cymbalta), and milnacipran (Savella). Your doctor may also recommend other medications to relieve specific symptoms. For example, they might recommend taking cyclobenzaprine or amitriptyline to improve the quality of your sleep. This may help you feel more alert and focused.
Brainteasers, crossword puzzles, and other mentally stimulating activities may also help ward off fibro fog. Chess, checkers, bridge, and jigsaw are good choices too. Games that require strategic thinking help keep your brain active and blood flowing.
Although it may seem contradictory, physical exercise can actually reduce pain caused by fibromyalgia. It can also relieve mental symptoms, report researchers in the . Exercise helps reestablish the natural neurochemical balance in your body. It also increases your production of feel-good endorphins. This may help you feel more focused and alert. It can also help alleviate symptoms of stress, anxiety, and depression.
Research published in the provides evidence of a link between fibromyalgia and . Low levels of vitamin D might increase your risk of fibromyalgia, as well as symptoms of anxiety and depression.
Your skin can produce vitamin D on its own when it’s exposed to sunlight. You can also get vitamin D from eating foods rich in this nutrient, such as fatty fish, eggs, cheese, and fortified products. In some cases, your doctor might recommend taking a vitamin D supplement.
A magnesium deficiency might contribute to feelings of fatigue or brain fog, too. If your doctor suspects you aren’t getting enough of this essential mineral, they might recommend changes to your diet. They might also encourage you to take a magnesium supplement.
A 2012 study published in examined the effects of magnesium supplementation on people with fibromyalgia. After taking magnesium citrate supplements for eight weeks, participants showed improvements in several symptoms. Those who took magnesium citrate with antidepressant medications showed even more improvements.
Some over-the-counter (OTC) supplements might help ease the symptoms of fibro fog. Other products won’t live up to the promises they make.
Always talk to your doctor before taking a new supplement, including vitamin and mineral supplements. They can help you understand the potential benefits and risks. For example, magnesium citrate can cause some side effects.
Acupuncture is a form of traditional Chinese medicine. It’s used to treat a variety of conditions. Some Western scientists believe it affects blood flow and nerve signals in your body.
According to the , some studies suggest that acupuncture may help relieve symptoms of fibromyalgia. Others have found no benefits. Since the risks involved in this complementary therapy are relatively low, you might decide it’s worth a try. Talk to your doctor about the potential benefits and risks.
A study published in the suggests that yoga may help reduce psychological symptoms of fibromyalgia. It may also relieve your pain. As an added benefit, this meditative exercise can help improve your flexibility, balance, and muscle strength.
Consider practicing yoga at least twice a week. Many community centers, gyms, and yoga studios offer classes for a variety of skill levels.
Massage therapy may help alleviate stress, anxiety, and depression associated with your condition. It might also relieve other physical and psychological symptoms of fibromyalgia.
More research is needed to test the effectiveness of massage therapy for fibromyalgia. In the meantime, ask your doctor if this complementary therapy might be right for you. You may find it soothes some of your symptoms.
There’s no one-size-fits-all approach to managing fibromyalgia. Symptoms can vary from one person to another. So can the best treatment options.
Work with your doctor to find treatment options that work for you. They might recommend medications, supplements, complementary therapies, or lifestyle changes. Always talk to them before making changes to your treatment plan. They can help you understand the potential benefits and risks.