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.

Step 1 Post your response to the discussion board.

Currently, nursing services are considered an expense for which healthcare organizations cannot bill separately. Respond to the following questions and, if appropriate, include personal experience as part of your answers:

• Why are healthcare organizations unable to bill separately for nursing services, and what is the impact on nurse leaders?
• What can the nursing profession, and specifically nursing leaders, do to change this issue?
• Why are nursing services considered an expense and not an income generator?

Step 2 Read other students’ posts and respond to at least two of them by Friday at 11:59pm Mountain Time.

Ask questions of the other students that promote further thinking and discussion on the topic. Consider the changes to billing identified by the other students. Do you agree or disagree that these changes can make an impact on nursing services? Why or why not?

Use your personal experience, if it’s relevant, to support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support opinions.

Health promotion week1 peers response 

respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines

1st peers post

Emilee Harper

WEEK 1 DISCUSSION 2

· Define health promotion in your own words.

 Health promotion, in my own words, is the process of empowering individuals, communities, and societies to enhance their overall well-being and achieve their highest level of physical, mental, and social health. It involves dedicated efforts to prevent illness, promote healthy behaviors, and address the encouragement of health to achieve optimal quality of life. 

· Discuss the differences in primary, secondary, and tertiary prevention.

1. Primary Prevention: This focuses on preventing the onset of health issues. It aims to reduce the risk of disease or injury before they occur. Examples include vaccinations, health education, and lifestyle interventions to promote healthy habits.

2. Secondary Prevention: Secondary prevention is about early detection and intervention to prevent the progression of a health issue. It includes activities like regular screenings, diagnostic tests, and prompt treatment to control a disease or injury in its early stages.

3. Tertiary Prevention: Tertiary prevention is geared towards minimizing the impact of established diseases or injuries and preventing their complications. It involves rehabilitation, disease management, and strategies to improve the patient's quality of life.

 

· Identify two patient-focused topics of interest from the Healthy People 2030 website that interest you. For each topic, identify an objective from the Healthy People 2030 website on which you would like to focus. Why are these topics of interest to you? Provide a rationale for your selections.

1. Topic 1: Mental Health and Mental Disorders

· Objective: “Increase the proportion of children, adolescents, and adults who receive treatment for a major depressive episode.”

· Rationale: Mental health is a critical but often stigmatized aspect of overall well-being. Focusing on increasing access to treatment for depression aligns with the goal of promoting mental health and reducing the burden of mental disorders.

2. Topic 2: Substance Abuse (Drug and Alcohol Use)

3.  

· Objective: “Reduce the proportion of people who misuse prescription drugs in the past year.”

· Rationale: The misuse of prescription drugs is a growing public health concern. Reducing this misuse can reduce the associated health risks, addiction, and adverse consequences on individuals and communities.

 

Increase the proportion of children and adolescents who get appropriate treatment for anxiety or depression – EMCD04. Increase the proportion of children and adolescents who get appropriate treatment for anxiety or depression – EMCD04 – Healthy People 2030. (n.d.).
https://health.gov/healthypeople/objectives-and-data/browse-objectives/children/increase-proportion-children-and-adolescents-who-get-appropriate-treatment-anxiety-or-depression-emc-d04

Prevention strategies – STATPEARLS – NCBI bookshelf. (n.d.).
https://www.ncbi.nlm.nih.gov/books/NBK537222/ Kisling LA, M Das J. Prevention Strategies. [Updated 2023 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

Reduce the proportion of people who misused prescription drugs in the past year – su12. Reduce the proportion of people who misused prescription drugs in the past year – SU12 – Healthy People 2030. (n.d.).
https://health.gov/healthypeople/objectives-and-data/browse-objectives/drug-and-alcohol-use/reduce-proportion-people-who-misused-prescription-drugs-past-year-su-12

 

2nd peer post

Melinda Goebel

Health Promotion is a huge factor in health care. It is about taking care of your health and preventing or treating disease and illness. Primary prevention is mostly about preventing damage to your health before it can occur. Secondary prevention is about preventing the illness from progressing and further damaging health. Tertiary prevention helps manage long term, complex health problems to improve life with the disease as much as a possible.

 

I chose to focus on Heart Disease and Stoke from the Health People 2030 website. I chose this because it relates so closely to my practice at work on a Heart and Vascular Unit. Another reasoning I had behind researching this topic is because it is so relevant in health promotion and heart disease effects so many Americans, when it could be prevented.

 

Part of the Heart Disease and Stroke topic included screening for atrial fibrillation. This objective caught my interest because it is so much more common than people realize and often people live with atrial fibrillation without knowing until a larger event, such as heart attack or stroke occur. It could do so much for Secondary Prevention if the general population had more of an understanding of atrial fibrillation and a way to screen.

 

Diabetes is a huge problem in the population of the United States and effects so many of all ages. As a nurse I about half of my patient will come in with type 2 diabetes. This is another disease that has so many other effects on the body and health that could be prevented or controlled.

 

Type 2 diabetes is occurring in children and young adults more often. This could be prevented with education on a balanced diet and the risk of being diabetic. There is also ways to control blood sugars and lower A1C in these younger generations that are being diagnosed with type 2 diabetes.

 

U.S. Department of Health and Human Services. (2021). Healthy People 2030. Health.gov. https://health.gov/healthypeople

due 10-16-23@10am

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem.

Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:

Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population.

Following the PICOT format, write a PICOT question in your selected area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).

Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. Note: This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology.

Articles must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. The PICOT question will also provide a framework for your capstone project.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignme