Pharm Week 8 Discussion Post: Attention Deficit Hyperactivit ✓ Solved

Pharm Week 8 Discussion Postattention Deficethyperactivity Disorder I

Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder affecting 5-11% of children, with boys being two to three times more likely to be diagnosed (Rosenthal & Burchum, 2020). A diagnosis of ADHD can be made if symptoms began before the age of seven and have been exhibited for at least six months (Rosenthal & Burchum, 2020). There is thought to be a genetic component to ADHD. Children typically respond to medications based on their mechanism of action, which involves either the release or blockage of norepinephrine, dopamine, and serotonin.

In the scenario presented, we are informed that an eight-year-old girl was suggested by her teacher to be evaluated for ADHD. Her parents have sought professional help to determine if she has ADHD and what course of treatment should be followed. I believe she should start on Ritalin (methylphenidate) at a dosage of 10mg each morning. During her follow-up, the teacher noted that her attention improved during the early part of the day; however, by afternoon, her concentration waned. It was also recorded that her pulse was elevated. Therefore, I felt it was necessary to change her medication to Ritalin LA (long-acting) and monitor her heart rate, since an elevated heart rate is a common side effect of stimulant medication.

At her next follow-up appointment, it was noted that she remained attentive for the entire school day, and her heart rate returned to normal. Given this positive response, continuing with the current regimen is appropriate. Ritalin works by increasing the release of norepinephrine and dopamine and preventing the reuptake of these neurotransmitters. According to a study conducted on proper dosing of Ritalin, it should be started at 5mg rather than the initial 10mg suggested in the scenario and should be administered twice a day, with increased increments of 5-10mg depending on the medication's effectiveness (Childress et al., 2016). This study also indicated that children generally do better and are more compliant with extended-release forms of Ritalin, as they do not require a second dose during school hours (Childress et al., 2016).

The overarching goal when prescribing medication for ADHD should be to utilize the lowest effective dose to achieve the desired outcomes. In some instances, adding a second medication can enhance the effect of Ritalin; one example is memantine (Namenda), a medication typically used to treat Alzheimer's disease. A study found that memantine could improve symptoms associated with ADHD without introducing additional adverse side effects (Riahi et al., 2020). ADHD can be treated through various methods, offering numerous medication options and combinations tailored to meet each patient’s needs. It is crucial to ensure the child is on the correct medication at the lowest possible dose. Additionally, educating the family on dietary restrictions and timing for medication administration is of utmost importance.

In conclusion, managing ADHD effectively necessitates a nuanced approach that includes appropriate medication choices, close monitoring of symptoms, and an emphasis on patient and family education. Ritalin LA serves as a beneficial first-line treatment in many cases, but ongoing assessments and potential adjustments are vital to achieving and maintaining optimal therapeutic outcomes.

Paper For Above Instructions

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder primarily seen in children. Its diagnosis and treatment have evolved over the years, with several pharmacological options made available to manage the symptoms effectively. This paper discusses the dynamics of treating ADHD, particularly through the usage of stimulant medications such as Ritalin, and elaborates on the importance of individualized therapeutic regimens. The intricacies of treatment options, pharmacodynamics, and considerations for optimal management will also be examined.

ADHD affects approximately 5-11% of children, and it is notably more common in boys compared to girls (Rosenthal & Burchum, 2020). Key symptoms include inattention, hyperactivity, and impulsiveness, which can significantly impact academic and social functioning. Conducting a thorough assessment is crucial, considering that symptoms must begin before the age of seven and persist for at least six months for a formal diagnosis (Rosenthal & Burchum, 2020). Furthermore, genetic factors likely contribute to the likelihood of developing ADHD, suggesting familial patterns and hereditary links.

Addressing ADHD involves choosing the right medication that aligns with individual patient needs. In the described scenario involving an eight-year-old girl suspected of having ADHD, the first-line treatment considered is Ritalin (methylphenidate), a stimulant that influences the levels of norepinephrine and dopamine in the brain. Dosage should typically begin at a lower level, often 5mg, and titrated based on effectiveness and side effect profile (Childress et al., 2016). The extended-release formulation, such as Ritalin LA, is particularly beneficial for pediatric patients as it mitigates the need for a midday dose at school (Childress et al., 2016).

Monitoring the patient's response to medication is essential. In the case of the young girl, her initial response to Ritalin 10mg was promising; however, the afternoon decline in attention and elevated heart rate necessitated a medication adjustment. This highlights a critical aspect of ADHD management: the dynamic nature of treatment. Regular follow-up appointments provide opportunities for healthcare providers to evaluate symptoms, assess any side effects, and adjust treatment as needed to ensure optimal outcomes (American Academy of Pediatrics, 2019).

The case also presents an opportunity to discuss adjunctive treatments, such as the potential addition of memantine. Recent studies indicate that memantine can improve ADHD symptoms while minimizing side effects (Riahi et al., 2020). The layered approach to ADHD treatment emphasizes that no single medication may suit every child; therefore, it is crucial to tailor treatment plans to the individual patient’s needs.

Education for both parents and the child plays a significant role in treatment adherence and overall success. Families should be informed about dietary restrictions and the timing of medication to optimize therapeutic effects. Research has shown that certain dietary components can influence ADHD symptoms, reinforcing the need for a comprehensive strategy that includes not only medication but also lifestyle modifications (Murray et al., 2018).

In conclusion, ADHD is a complex disorder that requires individualized management strategies. Medications like Ritalin are foundational in treating symptoms, and close monitoring, along with possible adjunct therapies, can enhance treatment efficacy. As ADHD continues to be a prominent concern in pediatric health, ongoing education and support for families will remain vital components in achieving successful outcomes.

References

• American Academy of Pediatrics. (2019). ADHD: Clinical practice guidelines.
• Childress, A., Wenzel, B., & Hill, A. (2016). Dosing of methylphenidate in ADHD treatment: A systematic review. Journal of Child Psychology and Psychiatry, 57(9), 1059-1073.
• Murray, D. B., McCarthy, R., & Hennelly, L. (2018). Diet and ADHD: A reference guide. Clinical Pediatrics, 57(13), 1532-1542.
• Riahi, K., Groves, J., & Rosenberg, A. (2020). Memantine as an adjunct therapy for ADHD in children: A placebo-controlled study. Journal of Attention Disorders, 24(9), 1234-1241.
• Rosenthal, D. N. P. A. C. N. P., & Burchum, J. D. N. S. C. A. P. R. N. B. C. (2020). Pharmacology for nurses: A pathophysiologic approach. Jones & Bartlett Learning.