Please See Rubric Detail Below

Learning Resources

Required Readings (click to expand/reduce)

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

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. https://academicguides.waldenu.edu/ld.php?content_id=51901492

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

  • Chapter 5, “Psychopharmacology”


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Required Media (click to expand/reduce)

CriticalThinkRx. (2019, June 9). Module 5: Specific drug classes: Focus on adverse effects [Video]. YouTube. https://youtu.be/Gbq6RnOsGKQ

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

I found these additional resources bellow and thought it could be helpful you. You are welcome to search for better journal article to work on the paper- Please try to keep journals within 5years publication.

ADHD

Magellan ADHD Clinical Practice Guideline (PDF)

The American Academy of Pediatrics’ (AAP) Clinical Practice Guideline for Diagnosis, Evaluation and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescent (2019)

AAP’s companion document to the guideline, Systemic Barriers to the Care of Children and Adolescents with ADHD (PDF)

Assignment 1: 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

To Prepare

Your Instructor will assign a specific disorder for you to research for this Assignment. My assigned diagnosis is ADHD

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)- My assigned diagnosis is ADHD

  • 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.

Rubric Detail

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Name: NRNP_4665_Week3_Assignment1_Rubric

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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.
23 (23%) – 25 (25%) 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.20 (20%) – 22 (22%) 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.18 (18%) – 19 (19%) 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.0 (0%) – 17 (17%) 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.
• 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?23 (23%) – 25 (25%) 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.20 (20%) – 22 (22%) 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.18 (18%) – 19 (19%) 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.0 (0%) – 17 (17%) 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.
• 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.23 (23%) – 25 (25%) The response accurately and concisely uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.20 (20%) – 22 (22%) The response accurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.18 (18%) – 19 (19%) The response somewhat vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.0 (0%) – 17 (17%) 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.
• 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.9 (9%) – 10 (10%) 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 (8%) – 8 (8%) The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations.7 (7%) – 7 (7%) Three evidence-based resources are provided to support the intervention recommendations, but they may only provide vague or weak justification.0 (0%) – 6 (6%) Two or fewer resources are provided to support the intervention recommendations. The resources may not be current or evidence based.
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 (5%) – 5 (5%) 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 (4%) – 4 (4%) 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 (3.5%) – 3.5 (3.5%) 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.
0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time.

No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English Writing Standards:

Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors4 (4%) – 4 (4%) Contains one or two grammar, spelling, and punctuation errors3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) grammar, spelling, and punctuation errors0 (0%) – 3 (3%) Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
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 (5%) – 5 (5%) Uses correct APA format with no errors4 (4%) – 4 (4%) Contains one or two APA format errors3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) APA format errors0 (0%) – 3 (3%) Contains many (five or more) APA format errors
Total Points: 100

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Attention Deficit Hyperactivity Disorder

Student’s Name

Department, University

Course Code

Instructor

Date

Attention Deficit Hyperactivity Disorder

Introduction

            Attention, Deficit Hyperactivity Disorder is a neurobehavioral disorder. Children are the most vulnerable to suffer from ADHD. Treatment for ADHD is either through medications and non-pharmacological interventions such as behavioral therapy. This paper aims to present medications and non-pharmacological interventions that the food and drug administration agency approve. The paper also involves a risk assessment of the approved medication and discusses the clinical practice guideline that influences diagnosis, assessment, treatment, and management of ADHD.

              The Food and Drug Administration agency has approved the use of Strattera (atomoxetine) to treat Attention Deficit Hyperactivity Disorder.  Strattera is a stimulant medication that increases noradrenaline in the brain. Atomoxetine is the first-line medication in treating ADHD. It can be used alone or with psychostimulants. Dexmethylphenidate is an off-label drug for ADHD that has been approved by the FDA (Pheils & Ehret, 2021). The brand name for Dexmethylphenidate is Focalin. It is a mild stimulant. It alters the functioning of chemical and natural substances in the patient’s brain.EndeavorRx device are a non-pharmacological intervention allowed by the FDA for ADHA treatment (Canady, 2020). Therapy through the non-pharmacological intervention is based on an interactive gaming system to increase the patient’s attention. EndeavorRx device cannot be used as a stand-alone therapy. Akili Selective Stimulus Management engine core technology is used in the development of EndeavorRx devices.

              Selecting treatment for ADHD might cause a significant problem for the patient. The risk assessment should fast relate the expected impacts and results for medications and non-pharmacological options. The type of medication recommended should be reevaluated based on the condition’s reoccurrence, psychotherapy efficiency such as cognitive behavioral therapy, and improvement in symptoms. My risk assessment when recommending treatment for ADHD would also consider physical growth and cardiovascular function. Stimulant medications for Attention Deficit Hyperactivity Disorder are faulted for causing stunt growth. It is imperative to ensure the medicines do not cause appetite suppression or compulsive eating for the child or adolescent. Since ADHD is associated with increased blood pressure and altered heart rate asymmetry, it is vital to check the patient’s heart condition and pulse rate before settling on a particular medication. Atomoxetine poses cardiovascular problems for patients with heart problems (Hennissen et al., 2017). However, Strattera is beneficial because it increases norepinephrine amounts, improves attention span, and reduces hyperactivity and counter impulsive behaviors (Ermer & Vik, 2017). Dexmethylphenidate causes restlessness, insomnia, anxiety, and irregular heartbeat, but it increases attention, controls impulses, and reduces hyperactivity.

           Clinical practice guidelines apply in Attention-Deficit/Hyperactivity Disorder. “Clinical Practice Guideline: Diagnosis and Evaluation of the Child with Attention-Deficit/Hyperactivity Disorder” helps in the comprehensive assessment of the condition, look for coexisting disorders and comorbid conditions (Shah, Grover, & Avasthi, 2019).  The Clinical practice guidelines give room for psychosocial interventions, behavioral/educational treatment, and improve care for ADHD patients .based on the clinical practice guideline; I would recommend treatment of Attention-Deficit/Hyperactivity Disorder by applying evidence-based methods, reducing inappropriate variations, enhance the appropriateness of practice, ensure patient safety, and ensure appropriate diagnostic treatment

           In summation, treatment for ADHD is either through medications, behavioral therapy, or a combination of both. Strattera is the first-line medication for ADHD. The drug can be used alone, with off-label medications or behavioral therapy. All types of treatment reduce hyperactivity and counter impulsive behaviors. Clinical practice guidelines influence ADHD. The guideline impacts the diagnosis process, treatment, and care outcomes.

References

Canady, V. A. (2020). FDA approves first video game Rx treatment for children with ADHD. Mental Health Weekly30(26), 1-7. https://doi.org/10.1002/mhw.32423

Ermer, D., & Vik, T. (2017). Atomoxetine Pharmacogenetics: Lessons Learned. South Dakota medicine: the journal of the South Dakota State Medical Association, 70(7), 294-296. doi: 10.2217/PGS.15.93

Shah, R., Grover, S., & Avasthi, A. (2019). Clinical practice guidelines for the assessment and management of attention-deficit/hyperactivity disorder. Indian journal of psychiatry61(Suppl 2), 176. https://dx.doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_543_18

Hennissen, L., Bakker, M. J., Banaschewski, T., Carucci, S., Coghill, D., Danckaerts, M., … & Buitelaar, J. K. (2017). Cardiovascular effects of stimulant and non-stimulant medication for children and adolescents with ADHD: a systematic review and meta-analysis of trials of methylphenidate, amphetamines and atomoxetine. CNS drugs31(3), 199-215. DOI 10.1007/s40263-017-0410-7