Advanced Psychopharmacology and Health Promotion

Unit 9 peer response. ADHD Medications. 800W. APA. 4 references due 10-30-23.

Instructions:

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Please be sure to validate your opinions and ideas with citations and references in APA format.

Mihaela

Unit 9 – ADHD Medications

1.
What screening tools can be used to affirm your initial diagnosis that Mr. Deliver meets the criteria for ADHD?

One commonly used screening tool is the Adult ADHD Self-Report Scale (ASRS). The ASRS consists of a series of questions that evaluate both inattentive and hyperactive-impulsive symptoms (Anbarasan et al., 2020). Another useful screening tool is the Conners' Adult ADHD Rating Scales (CAARS), which assesses various domains affected by ADHD, such as attention problems, hyperactivity/impulsivity, and executive functioning (Smyth et al., 2019).

2.
Further assessment determines that Mr. Deliver does meet the criteria for ADHD, inattentive type. What is the current recommendation for pharmacological treatment for Mr. Deliver?

Once it is confirmed through further assessment that Mr. Deliver meets the criteria for ADHD, inattentive type, the current recommendation for pharmacological treatment would typically involve stimulant medications such as methylphenidate or amphetamine derivatives. These medications have consistently shown efficacy in improving attention, reducing impulsivity, and enhancing executive functions in adults with ADHD (Farhat et al., 2022). Non-stimulant options like atomoxetine or viloxazine (norepinephrine modulator) may also be considered if there are contraindications or intolerance to stimulants (Mechler et al., 2022). However, considering Mr. Deliver's concerns about stigma and psychotropic medications' risks, it may be worth discussing non-pharmacological interventions as well. Cognitive-behavioral therapy (CBT) has demonstrated efficacy in managing symptoms of adult ADHD. CBT can help Mr. Deliver develop strategies to improve organization skills, time management, and enhance his ability to focus on tasks (Young et al., 2020).

3.
Assume that instead of Mr. Deliver being 36 years old, Thomas is a 13-year-old male that also meets the diagnostic criteria for ADHD, hyperactive type (Thomas is not on any medications at this age). How will your pharmacological treatment change?

In the case of Thomas, a 13-year-old boy diagnosed with ADHD hyperactive type who is not currently taking any medications, the most probable treatment approach would involve the use of stimulant medications. According to the American Academy of Pediatrics (AAP), stimulant medications like methylphenidate are recommended as first-line treatment options for children and adolescents with ADHD, as they have been shown effective in reducing symptoms and improving functioning (Shrestha et al., 2020). However it is important to monitor growth and potential side effects in pediatric patients (Vertessen et al., 2023).

References

Anbarasan, D., Kitchin, M., & Adler, L. A. (2020). Screening for adult adhd. 
Current Psychiatry Reports, 
22(12). 

https://doi.org/10.1007/s11920-020-01194-9Links to an external site.

Farhat, L. C., Flores, J. M., Behling, E., Avila-Quintero, V. J., Lombroso, A., Cortese, S., Polanczyk, G. V., & Bloch, M. H. (2022). The effects of stimulant dose and dosing strategy on treatment outcomes in attention-deficit/hyperactivity disorder in children and adolescents: A meta-analysis. 
Molecular Psychiatry, 
27(3), 1562–1572. 

https://doi.org/10.1038/s41380-021-01391-9Links to an external site.

Mechler, K., Banaschewski, T., Hohmann, S., & Häge, A. (2022). Evidence-based pharmacological treatment options for adhd in children and adolescents. 
Pharmacology & Therapeutics, 
230, 107940. 

https://doi.org/10.1016/j.pharmthera.2021.107940Links to an external site.

Shrestha, M., Lautenschleger, J., & Soares, N. (2020). Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: A review. 
Translational Pediatrics, 
9(S1), S114–S124. 

https://doi.org/10.21037/tp.2019.10.01Links to an external site.

Smyth, A. C., & Meier, S. T. (2016). Evaluating the psychometric properties of the conners adult adhd rating scales. 
Journal of Attention Disorders, 
23(10), 1111–1118. 

https://doi.org/10.1177/1087054715624230Links to an external site.

Vertessen, K., Luman, M., Swanson, J. M., Bottelier, M., Stoffelsen, R., Bet, P., Wisse, A., Twisk, J. R., & Oosterlaan, J. (2023). Methylphenidate dose–response in children with adhd: Evidence from a double-blind, randomized placebo-controlled titration trial. 
European Child & Adolescent Psychiatry. 

https://doi.org/10.1007/s00787-023-02176-xLinks to an external site.

Young, Z., Moghaddam, N., & Tickle, A. (2016). The efficacy of cognitive behavioral therapy for adults with adhd: A systematic review and meta-analysis of randomized controlled trials. 
Journal of Attention Disorders, 
24(6), 875–888. 

https://doi.org/10.1177/1087054716664413Links to an external site.

Ruth

Unit 9: Initial Discussion ADHD Medications

What screening tools can be used to affirm your initial diagnosis that Mr. Deliver meets the criteria for ADHD?

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neuropsychiatric disorder of childhood, with impairing symptoms persisting into adulthood in approximately 70% of cases. Several screening tools are available to help providers identify and diagnose ADHD. The World Health Organization (WHO) Adult ADHD Self-Report Scale Part A is the most commonly used screening tool for ADHD cases in adults. The tool is available in national and international ADHD guidelines.  The screening tool contains six questions that cover inattentive and hyperactive-impulsive symptoms. It also includes a threshold of four or more, which is used for probable ADHD.  The score is calculated according to the number of questions that meet the criteria: sometimes endorsing/often/very often for questions 1–3 and endorsing usually/very often for questions 4–6. However, this screening, even if the patient is positive, may not have an active diagnosis of ADHD; further evaluation is required to ensure symptoms are related to ADHD diagnosis (Chamberlain et al., 2021). 

Further assessment determines that Mr. Deliver does meet the criteria for ADHD, inattentive type. What is the current recommendation for pharmacological treatment for Mr. Deliver?

According to his age and diagnosis, the current recommendation for this patient will be amphetamine 12.5 mg daily. Recommend that the patient start CBT and encourage exercise. A study showed that ADHD drugs are more effective and tolerated by children and adolescents than adults; the reason for this discrepancy is unknown. Amphetamines, methylphenidate, atomoxetine, and modafinil cause weight loss in children, adolescents, and adults. Amphetamines and atomoxetine increased blood pressure in children and adolescents, and methylphenidate increased blood pressure in adults. Methylphenidate showed better symptom control with the most minor side effects for children and adolescents, and amphetamines produced the best results for adults (Gupta, 2018). 

Reference:

Chamberlain, S. R., Cortese, S., & Grant, J. E. (2021). Screening for adult ADHD using brief rating tools: What can we conclude from a positive screen? Some caveats. 
Comprehensive Psychiatry, 
106, 152224. https://doi.org/10.1016/j.comppsych.2021.152224

Gupta, S. (2018). Best First-Line ADHD Medications for Children, Adults: Study Results. 
Attitude. https://www.additudemag.com/adhd-drugs-methylphenidate-vs-amphetamine-treatment/

Mayo Clinic. (2023). Amphetamine (Oral Route). 

https://www.mayoclinic.org/drugs-supplements/amphetamine-oral-route/proper-use/drg-20150941Links to an external site.

A 56-year-old patient with newly diagnosed stage 1 hypertension has been referred to you for counseling regarding lifestyle modifications. He is married, with four children — two in high school, two in college. His job as a senior vice-president for a major retail chain requires that he work long hours and frequently eat at restaurants. He smokes two packs of cigarettes a day, has a body mass index (BMI) of 29 kg/m2, and a waist-hip ratio of 1.6. He usually drinks one to two dry martinis to relax after he gets home from work.

1. How would you develop a realistic plan to help this patient reduce his blood pressure and prevent complications?
2. Which risk factors would be among your top two or three priorities for this patient, and what interventions or recommendations would you provide for modifying these?

Instructions: 1 pg to 1 1/2 pg is long enough. APA style discussion post. has to have 3 references.

NSG 3150 – Healthcare Informatics

Week 8 Discussion

In this course wrap-up discussion, please reflect on your experience in the course
NSG 3150 – Healthcare Informatics and address the following items:

· Identify one of your major takeaways from this course.

· What aspect of the course helped you achieve this?

· How will you apply this knowledge to your practice and career?

Please be sure to provide appropriate APA-formatted in-text citations and references to support your response.

 Nearly everyone in the United States—and the world as a whole—has now been impacted by the COVID-19 pandemic. Everything from schools, to hospitals, to workplaces have been affected. Among the greatest impact seen has been the impact to the various lines of supplies in the medical field. Please review this article.

• Share how the pandemic has had an impact in both the demand for, and supply of healthcare goods and services.
• Describe the impact the supply chain disruption had on healthcare organizations in your own community in terms of financial impact, patient access and treatment decisions, or shortages of personal protective equipment (PPE) for essential healthcare personnel.