PATIENT CASE SCENARIO DEBATE
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.
In Week 5, you were assigned by Faculty to argue either the pro (for) or con (against) for a particular medication. You were also provided information for a patient case study scenario. Week 5 was your opportunity to conduct research for this debate.
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.
Support your answers with evidence-based, peer-reviewed scholarly literature.
Note: APA style format with citations and references will apply.
As a reminder, these were the assigned medications:
Pro Con
Amphetamine Amphetamine
Methylphenidate Methylphenidate
Alpha Adrenergic Agonist Alpha Adrenergic Agonist
Non-Stimulant Non-Stimulant
Post your response detailing your argument for the following:
• 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.
The Debate on ADHD Medication for Malcolm: Advocating for Methylphenidate
Introduction
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that can significantly impact a child's behavior and academic performance. In the case of Malcolm, a 9-year-old boy diagnosed with ADHD combined presentation, the choice of medication plays a crucial role in managing his symptoms and improving his daily functioning. This essay will argue in favor of using Methylphenidate for Malcolm and provide a comprehensive analysis of its mechanism of action, advantages, disadvantages, side effects, and considerations related to legal, ethical, and social implications.
Mechanism of Action and Suitability for the Patient
Methylphenidate is a central nervous system stimulant that works by increasing the levels of neurotransmitters like dopamine and norepinephrine in the brain. This mechanism of action is particularly suitable for patients with ADHD, as it helps regulate impulsive behavior, enhance focus, and improve attention span. Given Malcolm's symptoms of hyperactivity, impulsivity, and difficulty focusing, Methylphenidate can address these challenges by modulating neurotransmitter levels in his brain.
Advantages of Methylphenidate
- Different Administration Options: Methylphenidate is available in various formulations, including immediate-release and extended-release forms, providing flexibility in dosing and duration of action.
- Efficacy: Research studies have demonstrated the effectiveness of Methylphenidate in reducing ADHD symptoms and improving academic performance in children.
- Well-Established Safety Profile: Methylphenidate has been widely used for decades, with a well-documented safety profile when prescribed and monitored appropriately.
Disadvantages of Other Medication Options
- Amphetamine: While effective, Amphetamine medications may have a higher potential for abuse and carry a greater risk of side effects such as insomnia and decreased appetite.
- Alpha Adrenergic Agonist: Non-stimulant options like Alpha Adrenergic Agonists may have a slower onset of action and may not provide immediate symptom relief compared to stimulant medications like Methylphenidate.
Side Effects and Considerations
Potential side effects of Methylphenidate include decreased appetite, insomnia, and mood changes. It is essential to monitor Malcolm's growth, sleep patterns, and emotional well-being while on the medication. Additionally, considerations related to the long-term use of stimulant medications, such as monitoring for cardiovascular effects and potential impact on growth, should be evaluated regularly.
Legal, Ethical, and Social Implications
- Legal Implications: Prescribing Methylphenidate involves adherence to regulatory guidelines for controlled substances to prevent misuse or diversion.
- Ethical Implications: Ensuring informed consent from Malcolm's parents regarding the risks and benefits of medication treatment is crucial to uphold ethical standards in care.
- Social Implications: Addressing stigma associated with ADHD medication use in schools and communities is essential to support Malcolm's social well-being and academic success.
In conclusion,
Methylphenidate emerges as a suitable medication option for Malcolm based on its mechanism of action, advantages in administration and efficacy, compared to other alternatives. By considering the potential side effects and broader legal, ethical, and social implications of medication treatment, healthcare providers can make informed decisions to support Malcolm's well-being and academic progress effectively.