NRNP 6665 Prescribing for Children and Adolescents Essay Paper

NRNP 6665 Prescribing for Children and Adolescents Essay Paper

NRNP 6665 Prescribing for Children and Adolescents Essay Paper

Prescribing for Children and Adolescents

            Attention Deficit Hyperactivity Disorder (ADHD) is often initially diagnosed in childhood and frequently lasts into adulthood. It is among the most common reasons why pediatric psychology and behavioral clinics are visited by youngsters. Children with ADHD may have trouble focusing, display impulsive conduct and lack of self-control, or engage in excessive activity. One of the primary signs of ADHD is hyperactivity, which can make a child psychologically and socially incompatible at home, school, and in the community (Mechler et al., 2021). Thankfully, studies have shown that certain treatments can improve children’s attentiveness while reducing other symptoms. The following paper will analyze FDA- and non-FDA-approved medications for the management of ADHD.

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FDA-Approved Drug

The first-line treatment for ADHD in children is stimulants (Wolraich et al., 2019). Numerous stimulants that are all equally effective have had their therapy approved. The only variations are in dose, duration of action, and side effects. One of the stimulants that is recommended the most frequently, is Ritalin (Fu et al., 2022). When using the medicine, side effects are often tolerable for extended periods, although they might include anorexia, stomachaches, insomnia, and headaches.

Off-Label Drug

Wellbutrin, an antidepressant, is commonly utilized as an off-label treatment for ADHD. Even though stimulant medications are the first-line therapy for ADHD symptoms including impulsivity, restlessness, and inattention, Wellbutrin may help minimize these issues (Mechler et al., 2021).The Federal Drug Administration (FDA) originally authorized Wellbutrin’s usage as an antidepressant in 1985. Ever since it has been applied to the management of SAD and the reduction of nicotine withdrawal symptoms. Wellbutrin is categorized as an antidepressant, but because it strengthens brain processes that affect dopamine and norepinephrine, it is now often used as an “off-label” therapy for ADHD.

Nonpharmacological Intervention

CBT as a form of ADHD treatment may be advantageous for kids. Children may benefit from it as they grow their coping skills and self-control. As an illustration, a CBT therapist would advise an ADHD child to use a checklist to note key activities so they can stay more organized. For older children, a smartphone app and other useful features including timers, reminders, and calendars may be more useful (Fu et al., 2022). The most effective method for treating ADHD frequently involves combining therapy and medication. This is because medicine reduces the impact of symptoms fast. Therapy, on the other hand, takes longer to work but gives kids lifelong abilities.

Clinical Practice Guidelines

The American Academy of Pediatrics (AAP) clinical practice recommendations for the identification, assessment, and management of ADHD also complement the proposed therapeutic alternatives by incorporating several essential elements (Kollins et al., 2021). Screening for ADHD should begin between the ages of 4 and 18. Age-appropriate recommendations for therapy are made, and if pharmacotherapy is necessary, it should be adjusted to have the least negative impact on the child. Once ADHD has been identified using the DSM-V criteria, the patient should have ongoing therapy and be checked for other illnesses, such as emotional and behavioral problems, that commonly co-occur with ADHD.

Conclusion

The majority of kids may treat their ADHD symptoms safely and successfully with stimulant drugs. These drugs assist children with ADHD in improving their mental concentration and ignoring distractions, similar to how glasses assist individuals in focusing their vision to see. They are better able to focus and regulate their conduct as a result. As previously mentioned, children with ADHD who got both CBT and medication had considerable improvement.

References

Fu, D., Wu, D.-D., Guo, H.-L., Hu, Y.-H., Xia, Y., Ji, X., Fang, W.-R., Li, Y.-M., Xu, J., Chen, F., & Liu, Q.-Q. (2022). The Mechanism, Clinical Efficacy, Safety, and Dosage Regimen of Atomoxetine for ADHD Therapy in Children: A Narrative Review. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.780921

‌Kollins, S. H., Childress, A., Heusser, A. C., & Lutz, J. (2021). Effectiveness of a digital therapeutic as an adjunct to treatment with medication in pediatric ADHD. Npj Digital Medicine, 4(1). https://doi.org/10.1038/s41746-021-00429-0

Mechler, K., Banaschewski, T., Hohmann, S., & Häge, A. (2021). Evidence-based pharmacological treatment options for ADHD in children and adolescents. Pharmacology & Therapeutics, 230, 107940. https://doi.org/10.1016/j.pharmthera.2021.107940

Wolraich, M. L., Chan, E., Froehlich, T., Lynch, R. L., Bax, A., Redwine, S. T., Ihyembe, D., & Hagan, J. F. (2019). ADHD Diagnosis and Treatment Guidelines: A Historical Perspective. Pediatrics, 144(4), e20191682. https://doi.org/10.1542/peds.2019-1682

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Prescribing for Children and Adolescents

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

 

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Reference:

Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html

Links to an external site.

Resources

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCE

Learning Resources

Required Readings

• Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health

• Links to an external site.. American Psychiatric Association Publishing.
  • Chapter 14, “Psychosocial Interventions”
  • Chapter 15, “Psychotherapeutic Interventions”
  • Chapter 16, “Psychopharmacological Interventions”Links to an external site.
• Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
  • Chapter 43, “Pharmacological, Medically-Led and Related Treatments”
• Walden University. (n.d.). Developing SMART goals

• Links to an external site.. https://academicguides.waldenu.edu/ld.php?content_id=51901492Links to an external site.
• Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.
  • Chapter 5, “Psychopharmacology”

Required Media

• CriticalThinkRx. (2019, June 9). Module 5: 

Links to an external site.Specific drug classes: Focus on adverse effects

• Links to an external site. [Video]. YouTube. https://youtu.be/Gbq6RnOsGKQLinks to an external site.
• CriticalThinkRx. (2019, June 9). Module 2: Use of psychotropics with youth_prevalence and concerns
• Links to an external site. [Video]. YouTube. https://youtu.be/NRef-g4Ding

To Prepare

• Your Instructor will assign a specific disorder for you to research for this Assignment.
• Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

The Assignment (1–2 pages)

• Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
• 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 scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

By Day 7 of Week 3

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

1. To submit your completed assignment, save your Assignment as WK3Assgn1+last name+first initial.
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.

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Rubric

NRNP_6665_Week3_Assignment1_Rubric

NRNP_6665_Week3_Assignment1_Rubric

Criteria	Ratings	Pts
This criterion is linked to a Learning Outcome In 1–2 pages, address the following: • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.	25 to >22.0 ptsExcellent The response accurately and concisely explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents. 22 to >19.0 ptsGood The response accurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents. 19 to >17.0 ptsFair The response somewhat vaguely or inaccurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents. 17 to >0 ptsPoor The response vaguely or inaccurately explains interventions that would be appropriate for treating the assigned disorder in children and adolescents. Interventions may not represent the three types of interventions required, or response may be missing.	25 pts
This criterion is linked to a Learning Outcome • 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?	25 to >22.0 ptsExcellent The response accurately and concisely explains the risk assessment you would use to inform your treatment decision making. A concise and accurate explanation of the risks and benefits of each pharmacological intervention is provided. 22 to >19.0 ptsGood The response accurately explains the risk assessment you would use to inform your treatment decision making. An adequate explanation of the risks and benefits of each pharmacological intervention is provided. 19 to >17.0 ptsFair The response somewhat vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The explanation of the risks and benefits of each pharmacological intervention is somewhat vague or inaccurate. 17 to >0 ptsPoor The response vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The risks and benefits of each pharmacological intervention is vague or inaccurate. Or, the response is missing.	25 pts
This criterion is linked to a Learning Outcome • 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.	25 to >22.0 ptsExcellent The response accurately and concisely uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. 22 to >19.0 ptsGood The response accurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. 19 to >17.0 ptsFair The response somewhat vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. 17 to >0 ptsPoor The response vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. Or, the response is missing.	25 pts
This criterion is linked to a Learning Outcome • Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Be sure they are current (no more than 5 years old). Attach the PDFs of your sources.	10 to >8.0 ptsExcellent The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations. The resources reflect the latest clinical guidelines and provide strong justification for decision making. 8 to >7.0 ptsGood The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations. 7 to >6.0 ptsFair Three evidence-based resources are provided to support the intervention recommendations, but they may only provide vague or weak justification. 6 to >0 ptsPoor Two or fewer resources are provided to support the intervention recommendations. The resources may not be current or evidence based.	10 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 to >4.0 ptsExcellent Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 to >3.5 ptsGood Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3.5 to >3.0 ptsFair Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. 3 to >0 ptsPoor Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. No purpose statement, introduction, or conclusion were provided.	5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation	5 to >4.0 ptsExcellent Uses correct grammar, spelling, and punctuation with no errors 4 to >3.5 ptsGood Contains one or two grammar, spelling, and punctuation errors 3.5 to >3.0 ptsFair Contains several (three or four) grammar, spelling, and punctuation errors 3 to >0 ptsPoor Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding	5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.	5 to >4.0 ptsExcellent Uses correct APA format with no errors 4 to >3.5 ptsGood Contains one or two APA format errors 3.5 to >3.0 ptsFair Contains several (three or four) APA format errors 3 to >0 ptsPoor Contains many (five or more) APA format errors	5 pts
Total Points: 100