ANSWER
Constance on the Mechanism of Action of Amphetamines in the Treatment of ADHD
Amphetamines are stimulants of the central nervous system, including dextroamphetamine and combined amphetamine salts (Adderall). By mainly preventing their absorption and promoting their release from presynaptic neurons, they increase the amount of dopamine and norepinephrine that is available in the brain. This improves concentration and lessens hyperactivity and impulsivity, two major signs of ADHD.
Since Malcolm already displays impulsivity and violent tendencies, amphetamines may not be suitable for him due to their high potential for side effects, potential for overuse, and propensity to exacerbate behavioral outbursts.
Benefits and Drawbacks of Amphetamines
Benefits: Effectiveness in lowering the main symptoms of ADHD has been demonstrated.
Flexible dosage choices are provided by a variety of formulations, such as immediate-release and extended-release.
Within hours, there is a discernible improvement due to the quick start of action.
Drawbacks:
increased chance of adverse effects such irritation, appetite suppression, and insomnia.
potential for abuse or dependence, especially in young people.
might exacerbate Malcolm’s emotional dysregulation, which is already a problem.
Benefits and Drawbacks of Alternative Medicines
An effective substitute is offered by non-stimulants such atomoxetine (Strattera):
Benefits: Less chance of abuse or dependence.
Better suitable for kids who have aggressive tendencies or emotional instability.
Dosing once day increases adherence.
Drawbacks:
delayed beginning of effect; improvement might not be seen for two to four weeks.
limited effectiveness for certain patients when compared to stimulants.
Considerations and Adverse Effects
Assess the hazards associated with amphetamines, including the possibility of cardiovascular side effects (e.g., elevated blood pressure or heart rate), appetite suppression, and sleep difficulties. Malcolm may get more irritable and have more emotional outbursts.
Non-stimulants: Keep an eye out for uncommon but dangerous side effects, such as atomoxetine-induced liver damage or suicidal thoughts.
Social, Ethical, and Legal Consequences
Legal: Because amphetamines are classified as Schedule II drugs, prescribing them necessitates strict adherence to laws. Prescribers need to keep an eye out for any abuse or distraction.
Ethical: It’s crucial to weigh the dangers of side effects against efficacy. Malcolm believes it is morally required to give priority to a drug that controls impulsivity without making aggression worse.
Social: Malcolm’s social relationships and self-esteem may be impacted by the stigma associated with youngsters using stimulants, especially if peers or school personnel are aware of the prescription.
In conclusion
Malcolm believes that the dangers of amphetamines, such as the possibility of emotional dysregulation and abuse, outweigh the advantages. Atomoxetine, a non-stimulant substitute, might be a better way to deal with his emotional difficulties and impulsivity without making him more violent.
Citations
T. E. Brown (2021). Comorbidities with attention-deficit disorders in adults, adolescents, and children. Psychiatric Publishing, America.
Posner, K., Vaughan, B. S., Greenhill, L. L., & Kratochvil, C. J. (2020). In children and teenagers, attention deficit hyperactivity disorder. 137–147 in Pediatrics in Review, 39(3). The article https://doi.org/10.1542/pir.2018-0044
S. R. Pliszka (2021). evidence-based therapy for ADHD in kids and teenagers. 39(3), 506-521, Journal of Clinical Child & Adolescent Psychology. 10.1080/15374416.2020.1839212 https://doi.org
QUESTION
This week, you will present and defend your assigned stance (pro or con) and specific medication for your patient case study scenario with your peers. Within the debate, you will also share your perspective on why the alternative medication class would not be appropriate for the patient case scenario.
case study scenario
Malcolm is a 9-year-old male in the 4th grade at the public elementary school. Malcolm has recently been diagnosed with ADHD, combined presentation. Malcolm struggles with being fidgety and hyperactive; he often gets into trouble at school for blurting out answers, getting out of his desk when he should not be, and hitting other children when upset. Malcolm also has a hard time focusing on anything other than video games at home. His parents report homework takes “all night” though it should only take 30 minutes. Malcolm has assigned chores but often gets distracted. For example, Malcolm was to take out the trash but got distracted in the driveway while taking out the trash and left the full bag in the driveway. He often misplaces the combination code for the lock on the house door.
Please consider the medications and point of view based on your last name as follows:
Amphetamine (Con)
Post your response detailing your argument for the following: 250 words. Apa format
· What is the proposed mechanism of action of the medication(s)? Why might this be appropriate for the patients?
· What are the advantages or disadvantages to your class of medication (options for different administration, length of duration, etc.)?
· What are the advantages or disadvantages to the other medication options?
· What possible side effects or considerations need to be evaluated?
· Provide one example for each consideration—legal, ethical, and social implications—for prescribing the medication category.
Note: Your response needs to be supported by three 3 scholarly peer-reviewed resources located outside of your course learning resources.