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Week 8 ADHD
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Pharmacology for Psychological Disorders
Psychological disorders are conditions that involve a change in normal thinking, perceptions, behaviors, as well as relationships with other people. One of the common psychological disorders is the attention deficit hyperactivity disorder (ADHD), which mainly affects children, making them hyperactive and unable to make good judgment. Psychological disorders have negative impacts on patients’ lives, thus, advanced practice nurses should ensure that they have handled patients effectively by undertaking the right diagnosis, treatment, as well as patient education.
Treating a Patient with ADHD
An 8 years old Caucasian girl was brought to my attention after being suspected to have ADHD. Her family history indicated that she was inattentive and forgetting things she learned in school. Her class teacher indicated that she hardly followed instructions to the full and was beginning to lose interest in school work.
After taking into consideration the patient’s factors, as well as medical history, my first decision was to offer her Ritalin (methylphenidate), which are chewable tablets, at a dosage of 10 mg, which would be taken orally in the morning. Methylphenidate (MPH) is known for treating ADHD, where studies have indicated that MPH is effective in minimizing the core symptoms (Frolich, Banaschewski, Dopfner & Gortz-Dorten, 2014). Although the girl’s parents reported that she was showing improvement in overall academic performance after four weeks, they were concerned that she felt funny in her heart, and that the heart rate hit 130 beats within a minute.
In my second decision, I opted to switch to Ritalin LA at 20 gm daily, which should also be administered in the morning. This is the recommended daily dosage, although patients can begin treatment with only 10 mg daily (Drugs.com, 2019). When the patient returned after four weeks, she was reported to have improved in academic performance. The funny feeling had disappeared, and the pulse rate had dropped to 92 beats in a minute.
Consequently, my third decision was to maintain the current dose of Ritalin LA at 20 gm daily, which would be reevaluated after four weeks and dealing with any side effect. This is after ensuring that the patient’s symptoms have been contained, and no side effects were reported after four weeks (Laureate Education, 2019). At this level, the prescribing nurse should not think of increasing the dosage to avoid more side effects.
Impact of the Medication to the Patient’s Pathophysiology
My recommended will enable the patient to regain her attentiveness and communicate effectively with family members, as well as her teachers. Her performance in school will improve while the pulse rate would be maintained at the appropriate level. However, uncertainties concerning therapies, as well as the balance between benefits accrued from medicines, costs of medicines, and potential harm, should be catered for before starting treatment (Catala-Lopez et al., 2017). The rule of using stimulant medications is to utilize the lowest effective dose to avoid drug misuse.
Understanding the most appropriate treatment options will facilitate in making the right treatment plans for the patient, which can be replicated in the future. Clinical expertise is necessary in such cases to identify the right dosage should offer optimal clinical effects with minimized side effects, rather than having to try various doses to determine the right one (Frolich et al., 2014). If the patient does not show any improvement after taking Ritalin LA after the four-week period, the most appropriate thing would be to stop using the drug, rather than increasing the dosage.
Catala-Lopez, F., Hutton, B., Nunez-Beltran, A., Page, M. J., Ridao, M., Saint-Gerons, D. M., … & Moher, D. (2017). The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: a systematic review with network meta-analyses of randomised trials. PloS one, 12(7), e0180355.
Drugs.com. (2018, Jan. 31). Ritalin LA dosage. Retrieved from https://www.drugs.com/dosage/ritalin-la.html
Frolich, J., Banaschewski, T., Döpfner, M., & Görtz-Dorten, A. (2014). An evaluation of the pharmacokinetics of methylphenidate for the treatment of attention-deficit/hyperactivity disorder. Expert opinion on drug metabolism & toxicology, 10(8), 1169-1183.
Laureate Education (Producer). (2019). Attention deficit hyperactivity disorder [Interactive Media]. Baltimore, MD: Author