Advanced Pharmacology and Assignment: Off-Label Drug Use in Pediatrics Choice

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Advanced Pharmacology and Advanced

Pathophysiology

 

Test bank final exam NURS 6501 N-42- Advanced

Pathophysiology, Test bank Final exam NURS-

6521N-52-Advanced Pharmacology and

Assignment: Off-Label Drug Use in Pediatrics

 

Assignment: Off-Label Drug Use in

 

Pediatrics

 

The unapproved use of approved drugs, also called off-label use, with children is

quite common. This is because pediatric dosage guidelines are typically

unavailable, since very few drugs have been specifically researched and tested

with children.

When treating children, prescribers often adjust dosages approved for adults to

accommodate a child’s weight. However, children are not just “smaller” adults.

Adults and children process and respond to drugs differently in their absorption,

distribution, metabolism, and excretion.  

Photo Credit: Getty Images

 

Children even respond differently during stages from infancy to adolescence. This

poses potential safety concerns when prescribing drugs to pediatric patients. As an

advanced practice nurse, you have to be aware of safety implications of the off-label

use of drugs with this patient group.

To Prepare

 Review the interactive media piece in this week’s Resources and reflect on the

types of drugs used to treat pediatric patients with mood disorders.

 Reflect on situations in which children should be prescribed drugs for off-label

use.

 Think about strategies to make the off-label use and dosage of drugs safer for

children from infancy to adolescence. Consider specific off-label drugs that you

think require extra care and attention when used in pediatrics.

 

By Day 5 of Week 11

Write a 1-page narrative in APA format that addresses the following:

 Explain the circumstances under which children should be prescribed drugs for

off-label use. Be specific and provide examples.

 Describe strategies to make the off-label use and dosage of drugs safer for

children from infancy to adolescence. Include descriptions and names of off-label

drugs that require extra care and attention when used in pediatrics.

Reminder: The College of Nursing requires that all papers submitted include a title

page, introduction, summary, and references. The Sample Paper provided at the

Walden Writing Center offers an example of those required elements (available

at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this

formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

 Please save your Assignment using the naming convention “WK11Assgn+last

name+first initial.(extension)” as the name.

 Click the Week 11 Assignment Rubric to review the Grading Criteria for the

Assignment.

 Click the Week 11 Assignment link. You will also be able to “View Rubric” for

grading criteria from this area.

 Next, from the Attach File area, click on the Browse My Computer button. Find

the document you saved as “WK11Assgn+last name+first initial.(extension)” and

click Open.

 If applicable: From the Plagiarism Tools area, click the checkbox for I agree to

submit my paper(s) to the Global Reference Database.

 Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 11 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 11 Assignment draft and review the originality report.

Submit Your Assignment by Day 5 of Week 11

To participate in this Assignment:

Week 11 Assignment

 

Therapy for Pediatric Clients with

 

Mood Disorders

 

An African American Child Suffering

 

From Depression

 

 

 

Decision Point One

 

Begin Zoloft 25 mg orally daily

RESULTS OF DECISION POINT ONE

  Client returns to clinic in four weeks

 

  No change in depressive symptoms at all

Decision Point Two

 

Increase dose to 37.5 mg orally daily

RESULTS OF DECISION POINT TWO

  Client returns to clinic in four weeks

  Depressive symptoms decrease by 20%. Client reports

feeling a little bit better

 

Decision Point Three

 

Increase to 50 mg orally daily

 

Guidance to Student

At this point, sufficient symptom reduction has not been realized. Should either increase dose

or consider different SSRI. At 8 weeks post-initiation of therapy, there should have been a

significant (as defined as 50%) decrease in symptoms. This would be considered an adequate

trial of antidepressant and change in dose or to a different agent would be appropriate.

 

2 nd interactive media

 

iatric depression

 

Therapy for Pediatric Clients with

 

Mood Disorders

 

An African American Child Suffering

 

From Depression

 

 

 

Decision Point One

 

Begin Paxil 10 mg orally daily

RESULTS OF DECISION POINT ONE

  Client returns to clinic in four weeks

  Reduction in The Children’s Depression Rating Scale by 5

points overall, but with complaints of nausea, vomiting, and

diarrhea

 

Decision Point Two

 

Change to Prozac 10 mg orally daily

RESULTS OF DECISION POINT TWO

  Client returns to clinic in four weeks

  There is a 25% reduction in symptoms, client’s side effects

of nausea, vomiting, and diarrhea have resolved. Client

reports that he is feeling a “little bit better”

Decision Point Three

 

Increase dose to 20 mg orally daily

 

Guidance to Student

You have two equally compelling choices at this point. The client has only been taking the

current drug at its current dose for 4 weeks. It would be appropriate to continue at current

dose. Additionally, you could also increase the dose to 20 mg orally daily. A discussion of

risk/benefits should be had with the childs guardian regarding this and collaborative decision

making should occur. There is no indication at this point that augmentation agents are required

as the child is showing a partial response to therapy.

 

3 rd interactive media

 

Therapy for Pediatric Clients with

 

Mood Disorders

 

An African American Child Suffering

 

From Depression

 

 

 

Decision Point One

 

Begin Wellbutrin 75 mg orally BID

RESULTS OF DECISION POINT ONE

  Client returns to clinic in four weeks

  Child is unable to fall asleep at night

Decision Point Two

 

Change to Lexapro 10 mg orally daily

RESULTS OF DECISION POINT TWO

  Client returns to clinic in four weeks

  Child is tolerating Lexapro, and is sleeping at night. There

is a 40% reduction in symptoms

 

Decision Point Three

 

Increase dose to 15 mg orally daily

 

Guidance to Student

At this point, there is no indicating that you should change back to Wellbutrin as the child is

tolerating the current medication without mention of side effects. Also, the child is experiencing

a reduction in symptoms. You could also increase the dose to 15 mg orally daily, but the child

has only been taking the drug for 4 weeks at this point.

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