THIS ARE THE INSTRUCTIONS MY COLLEAGUE USED TO CREATE THE MAIN RESPONSE.
In Week 5, you were assigned by Faculty to argue either the pro (for) or con (against) for a particular medication. You were also provided information for a patient case study scenario. Week 5 was your opportunity to conduct research for this debate.
This week, you will present and defend your assigned stance (pro or con) and specific medication for your patient case study scenario with your peers. Within the debate, you will also share your perspective on why the alternative medication class would not be appropriate for the patient case scenario.
Support your answers with evidence-based, peer-reviewed scholarly literature.
Note: APA style format with citations and references will apply.
As a reminder, these were the assigned medications
THIS ARE YOU INSTRUCTIONS:
Read a selection of your colleagues’ posts. Focus specifically on those colleagues’ arguing the opposite of your claim.
Respond to your colleague that were assigned the opposite of your claim. Support or expand on your argument to refute their claims. Work to share additional perspectives on the issue described by your colleague.
Note: Your response needs to be supported by two (2) scholarly peer-reviewed resources located outside of your course Learning Resources.
THIS IS MY COLLEAGUE’S DISCUSSION POST PLEASE
RESPOND APPROPRIATELY
Manage Discussion Entry
Malcolm, a 9-year-old male client diagnosed with ADHD with combined presentation requires an appropriate management plan to enable him to calm down, concentrate on activities such as classwork and completing assignments, and control his impulsivity. Therefore, pharmacological agents combined with other non-pharmacological interventions are critical for achieving his treatment goals and maintaining his safety as well as preventing impulsiveness which may significantly affect the wellbeing and safety of other children. Thus, the two medications to consider for his case are methylphenidate and alpha-adrenergic agonist.
Methylphenidate is the first-line and FDA-approved agent for managing ADHD in children. The drug enhances norepinephrine and dopamine in the brain, promoting attention, behavior regulation, and impulsivity control. Therefore, the treatment could help Malcolm concentrate on classwork, complete his homework, and manage his impulsivity and hyperactive behavior. Methylphenidate’s benefits in managing ADHD include its well-established effectiveness in managing ADHD features in children, its rapid onset, and flexibility due to the existence of various formulations that allow tailored treatment to manage symptoms throughout the day (Banaschewski et al., 2024). Therefore, the drug can be given in the morning to regulate the symptoms and allow concentration throughout the day. However, the major drawbacks associated with methylphenidate use include decreased appetite which may affect growth and development, difficulty in sleeping, and palpitations and tachycardia (Eom & Kim, 2023). In addition, as a stimulant, the drug has a high risk for misuse, addiction, and diversion, especially in adolescents. Therefore, these factors must be critically analyzed before choosing pharmacotherapy.
The second option is alpha-adrenergic agonist agents which may include clonidine and guanfacine. Alpha-adrenergic agonists selectively enhance norepinephrine activity in the brain receptors and help reduce hyperactivity and impulsive behaviors. The major advantages of selecting alpha agonists over methylphenidate are that the drug has lower risks for abuse and addiction and makes it a safer option for treating the disease in children with a higher risk for stimulant and amphetamine addiction (Nazarova et al., 2022). However, these drugs may cause life-threatening effects such as dizziness, confusion, constipation, depression, and anxiety which may be challenging to manage in the 9-year-old child. In addition, the drug has a slow action and takes longer to become apparent in symptom management; therefore, the drug may result to delayed action for pediatric patients. Furthermore, this drug is less effective in managing ADHD features and should be considered as an alternative treatment when methylphenidate is contraindicated or concerns such as abuse and addiction arise.
Therefore, because Malcolm has never used any treatment to manage ADHD, the nurse practitioner should initiate the plan using methylphenidate. Methylphenidate is an FDA-approved treatment for managing the disease in the pediatric population. Considering the drug’s rapid onset of action and ability to manage the disease over a long period. The nurse practitioner should consider initiating the drug and instructing the client to take the medication in the morning to prevent insomnia, take frequent meals due to decreased appetite, and apply relaxation techniques (Burchum & Rosenthal, 2022). The legal and ethical considerations include autonomy which requires the nurse practitioner to provide detailed explanations about the existing alternatives, and the effects, benefits, and advantages of each medication to make an independent and informed choice. Beneficence and non-maleficence require promoting patient safety by developing a monitoring plan, including the child, parents, and teachers in the monitoring and develop a follow-up plan for evaluating effectiveness, adverse effects, tolerance, and addiction which may require a review of the disease management plan (Nazarova et al., 2022). Therefore, the nurse practitioner must engage the team collaboratively to attain the desirable healthcare goals. On the other hand, the social considerations include mobilizing for social support for all caregivers to offer effective care and support to the child to help meet the underlying needs.
References
Banaschewski, T., Häge, A., Hohmann, S., & Mechler, K. (2024). Perspectives on ADHD in children and adolescents as a social construct amidst rising prevalence of diagnosis and medication use. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1289157Links to an external site.
Burchum, J., & Rosenthal, L. (2022). Lehne’s pharmacology for nursing care (11th ed.). Saunders.
Eom, T.-H., & Kim, Y.-H. (2023). Clinical practice guidelines for attention-deficit/hyperactivity disorder: Recent updates. Clinical and Experimental Pediatrics (Online). https://doi.org/10.3345/cep.2021.01466Links to an external site.
Nazarova, V. A., Sokolov, A. V., Chubarev, V. N., Tarasov, V. V., & Schiöth, H. B. (2022). Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials. Frontiers in Pharmacology, 13(13). https://doi.org/10.3389/fphar.2022.1066988Links to an external site.
Pro Con
Amphetamine
Amphetamine
Methylphenidate
Methylphenidate
Alpha Adrenergic Agonist
Alpha Adrenergic Agonist
Non-Stimulant
Non-Stimulant
