Prescribing for Children and Adolescents Essay

Prescribing for Children and Adolescents Essay

            Attention-Deficit/Hyperactive Disorder is one of the most prevalent mental illnesses in children (ADHD). The CDC estimates that 6.1 million kids in the US have already been given an ADHD diagnosis. This equates to 9.4% of all children in the country (Mechler et al., 2021). Children with the illness exhibit abnormal hyperactivity and impulsivity, which makes it difficult for them to concentrate in class and sit still. Because of this, some kids don’t perform as well as they could. Thankfully, certain therapies have been shown to lessen the symptoms and enhance the kids’ concentration. The following paper will look at FDA and non-FDA-approved drugs for the treatment of ADHD, as well as the risks and advantages of each, in addition to nonpharmacological therapy methods that may be effective.

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FDA-Approved Drug

Stimulants are the first-line drug for treating ADHD in children (Wolraich et al., 2019). The therapy has been authorized for a wide variety of stimulants, all of which are equally effective. The dosage, length of action, and adverse effects are the only differences. Ritalin is one of the most often prescribed stimulants that I would suggest (Fu et al., 2022). Some typical side effects of stimulants include appetite suppression, stomachaches, sleeplessness, and headaches; however, they are usually bearable for long periods when taking the drug.

Off-Label Drug

Wellbutrin is a common off-label treatment for ADHD that I would suggest taking. The FDA has given this drug approval to treat major depression, seasonal affective disorder, and nicotine dependence (Mechler et al., 2021). Nonetheless, psychiatric professionals have used the drug off-label to treat ADHD in youngsters. This drug prevents the reuptake of norepinephrine and dopamine. Suicide is a significant risk factor for teenagers on antidepressants, thus it is vital to watch for suicidal ideation and alert the parents to the danger so they can watch them as well (Mechler et al., 2021). Nevertheless, no efficacy and safety have been shown, as with any antidepressant.

Nonpharmacological Intervention

ADHD therapy involves more than just taking medication. Behavioral therapy, psychoeducation, nutrition, and exercise are examples of non-pharmacological therapies that can help regulate impulsive behavior and enhance attention (Fu et al., 2022). I would advise behavioral school interventions and parent education in behavior control among these nonpharmacological therapies.

Clinical Practice Guidelines

Several crucial components are included in the clinical practice recommendations for the diagnosis, evaluation, and treatment of ADHD, and they also support the suggested treatment options (Kollins et al., 2021). Between the ages of 4 and 18, an examination for ADHD should be started. Age-specific treatment recommendations are made, and if medication is given, it should be adjusted so that the child receives the maximum benefit with the fewest negative effects. A diagnosis of ADHD should be made following the DSM-established V’s standards, and the patient should get chronic treatment and be evaluated for other illnesses that frequently co-occur with ADHD, such as emotional and behavioral disorders.

Conclusion

In conclusion, there are a variety of treatments that may be used to control ADHD. Nevertheless, as not all medications are appropriate for all patients, the advanced practitioner must be aware of the benefits and drawbacks of the many pharmacological choices as well as best practices when administering certain medications to various age groups. It’s important to remember that drug treatment may not always be the best or first choice, depending on the age and the severity of the symptoms. For younger preschoolers, nonpharmacological therapies may be preferred, but for other children, a mix of medication therapy and cognitive behavioral therapy may be most effective.

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.htmlLinks 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

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

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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

Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeIn 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 OutcomeWritten 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 OutcomeWritten 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 OutcomeWritten 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