Navigating ADHD Medication Classes: Pros and Cons in Clinical Practice

Discussion Assignment

Please select two of the below medication classes. Your primary post should outline arguments both for and against the medication class in the two patient cases below. The primary post is due by Wednesday. (To be clear, you are picking two of the medication classes and addressing the topics listed below for BOTH patients)

Pro vs Con

Amphetamine-Amphetamine

Methylphenidate-Methylphenidate

Alpha Adrenergic Agonist-Alpha Adrenergic Agonist

Non-Stimulant-Non-Stimulant

· 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.

Patient 1:

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.

Patient 2:

Jessica is a 32-year-old female that was recently diagnosed with ADHD. She was referred to your office by the psychologist that completed the ADHD assessment. Jessica has always struggled in school and jobs. She is often “written up” at her job for not completing tasks that are assigned to her. She becomes easily distracted by her other co-workers. She finds herself spending a lot of time conversing with colleagues. Her colleagues are frequently annoyed with her for constantly talking to them and interrupting their work and tasks. Jessica is here to discuss medication options to treat ADHD.

· Goldin, D. S. (2023).  Fast facts for psychopharmacology for nurse practitioners. Springer Publishing.

· Chapter 9, “Stimulants/Neurodevelopmental Disorders” (pp. 178–208)

· Chapter 10, “Antidementia” (pp. 208–227)

· American Academy of Pediatrics. (2019, October).  Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescentsLinks to an external site. .  Pediatrics, 144(4), Article e20192528. https://doi.org/10.1542/peds.2019-2528

· Drugs.comLinks to an external site. . (2023). https://www.drugs.com/ Note: Please use the following resource to check the most up-to-date box warnings, FDA approvals and indications, recommendations for follow-up evaluations, changes, etc.

· CHADD’s National Resource Center on ADHD. (2023).  ADHD medications approved by the U.S. Food and Drug Administration: Stimulant medications. https://d393uh8gb46l22.cloudfront.net/wp-content/uploads/2020/02/ADHD-Medications-Approved-by-FDA-2.23.pdf Note: Utilize this medication table resource to familiarize yourself with the medications aligned with the topics presented this week.