Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. Assessing and Treating a Patient with Attention Deficit Hyperactivity Disorder Assessing and Treating a Patient with Attention Deficit Hyperactivity Disorder At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision-making when prescribing medication for this patient. Decision #1 (1 page) Which decisi

Assessing and Treating a Patient with Attention Deficit Hyperactivity Disorder

Katie, a Caucasian 8-year-old girl, is brought to the office by her parents after her teacher suspected that she could have ADHD. They were sent to the office for further evaluation by their PCP, who brought along a “Conner’s Teacher Rating Scale-Revised” form that Katie’s teacher had completed. The form highlights Katie’s difficulties with spelling, reading, and math, as well as her lack of focus, distractibility, and forgetfulness. The teacher also mentioned Katie’s short attention span, lack of interest in schoolwork, complete lack of ability to follow instructions, and beginning projects that she never finishes. Katie’s parents say she doesn’t have ADHD since she is not hyperactive, rebellious, or short-tempered.

Katie, during the assessment, says that she feels okay and there is nothing wrong with her. She notes art and recess are her favorite topics and claims that the other subjects are boring, difficult, and unsettling. She freely admits to daydreaming about activities she thinks are fun during class. She adds that she adores her parents and has no issues at home. She says she’s never been mistreated or bullied and has no additional worries.

According to Katie’s mental status examination, she is physically and verbally well-developed for her age. She is dressed appropriately for the weather and is aware of persons, places, times, and events. She is in a cheerful, euthymic mood with no indications of hallucinations, delusions, or paranoid thinking. She can do activities requiring serial counting without trouble, and her attention and focus are grossly intact. She denies having any suicidal or homicidal ideation, and her insight and judgment are age-appropriate. Katie is diagnosed with predominantly inattentive attention deficit hyperactivity disorder.

Decision Point #1

The first decision in managing Katie’s condition is to begin Wellbutrin (Bupropion) XL 150 mg orally daily. This decision is made because Katie’s primary presentation is predominantly inattentive, a type of ADHD. This shows her brain has trouble focusing, organizing, and remembering information or actions. Wellbutrin is a norepinephrine reuptake inhibitor (NRI). The decision to use Wellbutrin (Bupropion) XL 150 mg is supported by evidence as research has shown that Bupropion has proven to be effective and safe in managing children, adolescents, and adult populations with depressive and ADHD-I symptoms (Kweon & Kim, 2019; Ng, 2017).

The other two options, Intuniv extended release 1 mg and Ritalin (methylphenidate) chewable tablets 10 mg were not selected for various reasons. For instance, although Intuniv extended release 1 mg is effective in managing ADHD, it focuses on addressing factors of hyperactivity and impulsivity, which Katie does not present. On the other hand, although Ritalin (methylphenidate) chewable tablets 10 mg is a stimulant and first-line choice to address predominantly inattentive-type ADHD, it is not selected due to considerations of tolerability and potential side effects of stimulant medications on Katie, who is only 8-years-old. Additionally, stimulants risk worsening comorbid mental issues such as lack of sleep, mood, and anxiety disorders (Ng, 2017).

Selecting Wellbutrin (Bupropion) XL 150 mg as the first choice for Katie aims at her inattention and related symptoms such as distractibility and forgetfulness. It will also reduce the risk of hyperactivity, impulsivity, and other side effects associated with the other stimulant options (Ng, 2017). Ethical considerations will guide decisions and communication with Katie and her parents. For instance, ethical considerations such as safety and beneficence guide medication choices, such as the need to avoid side effects and associated risks. Additionally, since Katie cannot make her own decisions, autonomy is considered in decisions as her parents are informed of the possible choices and their benefits and risks and are involved in the selection of the medications. Top of Form

Decision Point #2

The second decision was to educate Katie’s parents that Bupropion sometimes causes suicidal ideation in children and that they needed to restart administering the drug at the previous dose. Educating Katie’s parents on the side effects of Bupropion and why they needed to continue with the medication was to address their fears and risks of discontinuing the medication. Sometimes, the parent’s and child’s beliefs, attitudes, and concerns affect the adherence to pharmacological treatment of ADHD (McCarthy, 2014). Non-adherence to medication treatment is associated with costly wastage of medications as well as a risk factor for increased ill health (While 202