Question

ADHD: CB is a 10-year-old male patient who is having difficulty in school. He fidgets constantly, gets up frequently to walk around, even if it is not appropriate to do so. He has difficulty staying on task and completing assigned work. He lives with his parents and younger sister. His father has a history of ADHD, bipolar and substance abuse disorder (pain pills, stimulants, and methamphetamine). His mother is obese with type II diabetes.

1. There are several medications that can be used to manage this patient’s ADHD. Identify three different medications that would represent potential therapeutic options taking into consideration the history of substance abuse in the family.
2. How does each of the medications identified work to manage ADHD symptoms?
3. In your opinion, which would represent the best therapeutic option and why? Provide specific dosing information, monitoring and patient education for the mediation selected.

Answer 1

a, medication:
Atomoxetine
Concerta
Fluoxetine
b, Atomoxetine -It is used to treat ADHD as a part of a total treatment plan. It works by restoring the balance of some natural substance(neurotransmitter) in the brain
Concerta: This medicine for a patient with a history of drug dependence. It is a CNS stimulant and helps increase the ability to pay attention and focus on activity.
Fluoxetine: It is a norepinephrine-dopamine reuptake inhibitor used to treat ADHD.
c, Atomoxetine has the best therapeutic option, because it is a nonstimulant to treat ADHD and approved by FDA has less effective and side effects. It works in neurotransmitter and it is not a control substance. so that people can avoid abuse the medicine
Dose: 0.5mg/kg oral once daily.
Monitoring:
-monitor child for side effects and allergic reaction
- Monitor the vital signs and intake and output
- Monitor child behavior and changes and any unusual symptoms
- Monitor child growth
Patient education:
- Advice the parents to give medication at the correct time with liquid. should not chew or crush the medicine.
- Never overdose the medicine or stop the medicine without doctor advice.
-Carefully monitor the child every second