Psychopharmacologic Treatment Case: A Young Caucasian Girl with ADHD

Psychopharmacologic Treatment of Psychopathology
Week 9: Case Study: A Young Caucasian Girl with ADHD 
Name
Institution
Date
Background - Attention Deficit Hyperactivity Disorder a Young Girl With ADHD
The 8 year old Caucasian female is inattentive, in the classroom easily distracted and forgets things she already learned. Conners Teacher Rating Scale-Revised, and the scale was used to determine whether the child had Attention deficit hyperactivity disorder (ADHD). The diagnosis was Attention deficit hyperactivity disorder, predominantly inattentive presentation
Decision Point One
Decision choice: Begin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING
The other choices were “Begin Wellbutrin (bupropion) XL 150 mg orally daily” and “Begin Intuniv extended release 1 mg orally at BEDTIME”. I did not choose the Wellbutrin (bupropion) option as in extreme cases there is a risk of suicidal ideation and irregular heartbeat, and the FDA medication is approved for depressive disorder, and Wellbutrin is most prescribed for adults. I did not choose the intuniv (guanfacine) option as it takes a few weeks to experience the maximum therapeutic benefits of the medication (Stahl, 2014).
The goal of using Ritalin (methylphenidate) is the reduction in ADHD symptoms, specifically her inattentiveness, which is interrupting her school functioning and learning (Stahl, 2014). I hoped to control her ADHD symptoms so that she would become more attentive in class and not be as distracted as before prior to the intervention.
I expected that there would be improvement in the symptom during and after the treatment, but after some time, Katie has started daydreaming again. The heart rate was also elevated and was measured as 130 beats per minute. When using Ritalin (methylphenidate), there is a risk of slight increase in the blood pressure level and heart rate.
When considering the client’s pharmacokinetic and pharmacodynamic processes age and the behavior of the client are considered. At a young age individuals can have different sensitivities on the medications and drug response is different than that of adults in the chemical absorption, distribution and metabolism of the drugs.
Ritalin mainly works by increasing norepinephrine mostly the dopamine actions by blocking their reuptake. Additionally, the medication enhances dopamine and norepinephrine actions in some regions of the brain regions, which is associated with better attention, concentration and executive function (Stahl, 2014). Besides this, there is enhancement in dopamine actions in different brain regions, which may improve hyperactivity. Similarly, enhancement of dopamine and norepinephrine in some other brain regions such as the hypothalamus and medial prefrontal cortex likely improve depression, and fatigue (Stahl, 2014).
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