Factors that Influence Pharmacokinetic and Pharmacodynamic Processes in Pediatric Clients

Factors that Influence Pharmacokinetic and Pharmacodynamic Processes in Pediatric Clients

When pediatric clients present with mood disorders, the
process of assessing, diagnosing, and treating them can be quite complex.
Children not only present with different signs and symptoms than adult clients
with the same disorders, but they also metabolize medications much differently.
As a result, psychiatric mental health nurse practitioners must exercise
caution when prescribing psychotropic medications to these clients. For this
Assignment, as you examine the client case study in this week’s Learning
Resources, consider how you might assess and treat pediatric clients presenting
with mood disorders.

Note: This Assignment is the first of 10 assignments that
are based on interactive client case studies. For these assignments, you will
be required to make decisions about how to assess and treat clients. Each of
your decisions will have a consequence. Some consequences will be
insignificant, and others may be life altering. You are not expected to make
the “right” decision every time; in fact, some scenarios may not have a “right”
decision. You are, however, expected to learn from each decision you make and
demonstrate the ability to weigh risks versus benefits to prescribe appropriate
treatments for clients.

Learning Objectives

Students will: Assess client factors and history to develop personalized
plans of antidepressant therapy for pediatric clients

Analyze factors that influence pharmacokinetic and
pharmacodynamic processes in pediatric clients requiring antidepressant therapy

Evaluate efficacy of treatment plans

Analyze ethical and legal implications related to
prescribing antidepressant therapy to pediatric clients

Learning Resources

Note: To access this week’s required library resources,
please click on the link to the Course Readings List, found in the Course
Materials section of your Syllabus.

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Required Readings

Note: All Stahl resources can be accessed through the Walden
Library using this link. This link will take you to a log-in page for the
Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013).
Stahl’s essential psychopharmacology: Neuroscientific basis and practical
applications (4th ed.). New York, NY: Cambridge University Press.

Note: To access the following chapters, click on the Essential
Psychopharmacology, 4th ed tab on the Stahl Online website and select the
appropriate chapter. Be sure to read all sections on the left navigation bar
for each chapter.

Chapter 6, “Mood Disorders”

Chapter 7, “Antidepressants”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New
York, NY: Cambridge University Press.

Note: To access the following medications, click on the The
Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the
appropriate chapter. Be sure to read all sections on the left navigation bar
for each chapter.

Review the following medications:

amitriptyline

bupropion

citalopram

clomipramine

desipramine

desvenlafaxine

doxepin

duloxetine

escitalopram

fluoxetine

fluvoxamine

imipramine

ketamine

mirtazapine

nortriptyline

paroxetine

selegiline

sertraline

trazodone

venlafaxine

vilazodone

vortioxetine

Magellan Health, Inc. (2013). Appropriate use of
psychotropic drugs in children and adolescents: A clinical monograph. Retrieved
from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf

Rao, U. (2013).
Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791.
doi:10.1002/da.22171

Note: Retrieved from Walden Library databases.

Vitiello, B. (2012). Principles in using psychotropic medication
in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child
and Adolescent Mental Health. Geneva: International Association for Child and
Adolescent Psychiatry and Allied Professions. Retrieved from
http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf

Poznanski, E., &
Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA:
Western Psychological Services.

Note: Retrieved from Walden Library databases.

Required Media

Laureate Education (2016e). Case study: An African American
child suffering from depression [Interactive media file]. Baltimore, MD:
Author.

Note: This case study will serve as the foundation for this
week’s Assignment.

Optional Resources

El Marroun, H., White, T., Verhulst, F., & Tiemeier, H.
(2014). Maternal use of antidepressant or anxiolytic medication during
pregnancy and childhood neurodevelopmental outcomes: A systematic review.
European Child & Adolescent Psychiatry, 23(10), 973–992.
doi:10.1007/s00787-014-0558-3

Gordon, M. S., & Melvin, G. A. (2014). Do
antidepressants make children and adolescents suicidal? Journal of Pediatrics
and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655

Seedat, S. (2014). Controversies in the use of
antidepressants in children and adolescents: A decade since the storm and where
do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v.
doi:10.2989/17280583.2014.938497

To prepare for this Assignment:

Review this week’s Learning Resources. Consider how to
assess and treat pediatric clients requiring antidepressant therapy.

The Assignment

Examine Case Study: An African American Child Suffering From
Depression. You will be asked to make three decisions concerning the medication
to prescribe to this client. Be sure to consider factors that might impact the
client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with
evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision?
Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve
with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with
evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision?
Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve
with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with
evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision?
Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve
with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your
treatment plan and communication with clients.

Topic 1 DQ 1

Oct 3-5, 2022

What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?

According to Hart (1994, p. 23), spirituality is the way a person lives out their beliefs in daily life and the way they “respond to the end conditions of individual existence” (Bożek, Nowak, , & Blukacz, 2020).A sense of peace and well-being are generated by spirituality, which is defined by faith, a search for life’s meaning and purpose and a feeling of belonging with one another. Through spiritual connection life satisfaction may increase or make it easier to accommodate illness or disability. Although, the idea of spirituality encompasses a huge range of personal experiences and convictions. Every individual has a unique perspective on spirituality. We may develop more comprehensive and compassionate healthcare systems by addressing the spiritual needs of our patients.

Nurses are being required more and more to recognize and respond to spiritual issues because of the emphasis on holistic care and meeting the requirements of each individual patient. Physical healing, pain relief, and personal development might result from attending to the patient’s spiritual needs. The nurse must attend to the patient’s emotional as well as physical demands in order to meet their total needs.The way in which we provide patient care would be influenced by our personal understanding of spirituality. For example, my spiritual beliefs consist of treating everyone with respect, compassion, care and equality regardless of their health status, race, spiritual view, gender, etc. I can take that into consideration into my practice by providing culturally competent, holistic care so I can better understand what I can do to assist the patient’s physical, spiritual, and mental wellbeing. Further, hospitals are held liable by The Joint Commission (TJC) for upholding patient rights, which includes making accommodations for cultural, religious, and spiritual values. The bodies, minds, and spirits of patients must all be taken into consideration by healthcare practitioners and systems (Swihart, Yarrarapu, & Martin, 2021).

Bożek, A., Nowak, P. F., & Blukacz, M. (2020). The Relationship Between Spirituality, Health-Related Behavior, and Psychological Well-Being. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.01997

Swihart, D.L., Yarrarapu ,S.N.S & Martin R.L. (2021). Cultural Religious Competence In Clinical Practice. StatPearls Publishing https://www.ncbi.nlm.nih.gov/books/NBK493216/