Mod 6: Special Populations – The Use of Methylphenidate Pharmacological Therapy in the Treatment of Pediatric ADHD
Mod 6: Special Populations – The Use of Methylphenidate Pharmacological Therapy in the Treatment of Pediatric ADHD – Review the medications in Chapter 8 of the textbook. Discuss one pharmacological therapy used in children. What age group can this drug be prescribed to? What is the purpose of the drug…
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Mod 6: Special Populations – The Use of Methylphenidate Pharmacological Therapy in the Treatment of Pediatric ADHD
Paper details
Review the medications in Chapter 8 of the textbook. Discuss one pharmacological therapy used in children. What age group can this drug be prescribed to? What is the purpose of the drug? What are the risks and benefits? What concerns may you have in prescribing this medication to a child? What education does the child’s parents need? Locate at least one scholarly website or video that discusses the medication. Adams, M., Holland, N., & Urban, C. (2014). Pharmacology for nurses: A pathophysiologic approach (4th ed.). Upper Saddle River, NJ: Pearson Education Inc. (Chapters 8 & 42)
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Solution
The Use of Methylphenidate Pharmacological Therapy in the Treatment of Pediatric ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder caused by a chemical imbalance in one’s brain, resulting in the inability to pay attention, hyperactivity, and lack of interest impulsivity. ADHD is among the most prevalently diagnosed neurobehavioral disorders in school-aged children, with an estimated prevalence of 6%-12% in America. Pharmacotherapy the treatment of illnesses through the administration of medication. Effective management of ADHD is essential for children, and it includes pharmacological therapy such as the use of non-stimulant and stimulant drugs, non-pharmacologic treatments, or a blend of the various treatment modalities (Huss et al., 2017).
ADHD is extensively labeled or known for its use of stimulants, which are the cornerstone of prescribed medication. Medical professionals can observe stringent approaches in the selection and modification of pharmacological agents to help treat ADHD while collaborating with caregivers, families, medical colleagues, and educational professionals to develop proper treatment plans. Generally, drugs used for ADHD management are safe and show efficacy. Due to the pattern of stimulants in the treatment of ADHD, there are both detrimental and beneficial impacts on children.
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Methylphenidate pharmacological stimulant is applicable for the treatment of ADHD after a failure of behavioral intervention as it provides a significant improvement. Children over the age of 4 years, or between 4-17 years, can use this pharmacological therapy. However, initiation of methylphenidate treatment in children with ADHD at an early age reduces the risk for adverse outcomes and may yield beneficial long-term impacts (Huss et al., 2017).
Stimulants aid in the enhancement of arousal of the prefrontal cortex. Methylphenidate boosts dopamine and norepinephrine neurotransmission in the prefrontal cortex. Methylphenidate uses its effect from obstructing presynaptic dopamine transporters of the principal adrenergic neurons and also blocks norepinephrine transporters at a lower degree. Thus, increasing the concentration of dopamine in the synaptic cleft, augmenting dopaminergic neurotransmission.
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Clinical monitoring during the methylphenidate treatment includes heart rate and blood pressure measurements, sleep, mental and behavioral changes, neurological assessments, and growth parameters. Approximately 30% of children with methylphenidate therapeutic stimulant dosages report reduces appetite, although this impact is clinically insignificant or transient.
The medication causes temporary headaches, behavioral rebound, increase in BP and heart rate, dysphoria/irritability, exacerbation of tics (not frequent), sleep problems (sleep latency, lowered sleep efficiency, and short sleep duration), and cognitive issues such as psychosis, euphoria, severe depression, and mania (Pliszka et al., 2017). However, the benefits of using methylphenidate include the improvement of multiple core symptoms of the illness- reduction of impulsivity and hyperactivity, helping children with concentration. It may also aid in bettering the quality of life and general behavior of pediatric ADHD.
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There are various concerns associated with the use of methylphenidate medication such as cardiovascular disease, epilepsy, and around 20% of the ADHD children are involved with underlying chronic tic disorders (Pliszka et al., 2017). ADHD pediatrics under methylphenidate medication also have a likelihood to develop at least a single ADR (adverse drug reaction). Methylphenidate recipients with many organ-systems show an adverse reaction, and epileptic children experience complications.
Cardiovascular negative effects due to methylphenidate are hypertension and tachycardia, particularly for chronic methylphenidate users. Also, the rate of seizures in ADHD children under methylphenidate is approximately double more prevalent than the general population. Caregivers and parents require education for the provision of optimum care for ADHD pediatrics.
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Significant physician-parent interactions are essential during the treatment of ADHD children. These interactions may involve family education, which is vital in monitoring, drug administration at home, and management of the illness. Parents also require instruction on how to deal with ADHD children to develop ways of managing their children positively and inclusively.
Accomplishing parents’ and family’s educational needs is critical in primary care settings (Adams, Holland, & Urban, 2014). This is due to the uniqueness of each patient as they present different attitudes and preferences to their medical encounters, and parents have to show support. Improvement of parents’ knowledge and correctio of their myths helps in decreasing treatment resistance, resulting in improved ADHD prognosis and a decrease in complications during care.
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References
- Adams, M., Holland, N., & Urban, C. (2014). Pharmacology for nurses: A pathophysiologic approach (4th ed.). Upper Saddle River, NJ: Pearson Education Inc. (Chapters 8 & 42)
- Huss, M., Duhan, P., Gandhi, P., Chen, C., Spannhuth, C., & Kumar, V. (2017). Methylphenidate dose optimization for ADHD treatment: review of safety, efficacy, and clinical necessity. Neuropsychiatric Disease and Treatment, Volume 13, 1741-1751. DOI: 10.2147/ndt. s130444
- Pliszka, S., Wilens, T., Bostrom, S., Arnold, V., Marraffino, A., & Cutler, A. et al. (2017). Efficacy and Safety of HLD200, Delayed-Release and Extended-Release Methylphenidate, in Children with Attention-Deficit/Hyperactivity Disorder. Journal of Child and Adolescent Psychopharmacology, 27(6), 474-482. DOI: 10.1089/cap.2017.0084
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