Side Effects and Drug

Katie & ADHD

What will be covered and described in this report is a series of actions and reactions to the plight and challenges faced by Katie. Katie is a child that is ostensibly developed and otherwise put together for her age. However, her academics are problematic and the primary (if not only) problem seems to be that she has little ability to pay attention or do things that so not directly and completely interest her. What will follow in this report is a listing of three decision points and why those precise decisions were made. The history involved will not be dwelled on given that this has already been covered to a great extent. However, the proper internal and scholarly justifications will be offered along the way to support the decisions made.

Analysis

Decision One

The first decision made was to put Katie on a medication. Despite the doubt and apprehension of her parents, it became pretty apparent that ADHD was indeed the culprit and that a medicinal intervention would be the way to approach it. As for why Ritalin was chosen instead of the other two drugs listed, this is because Ritalin is the commonly accepted first-line medication for ADHD. Of course, this includes ADHD in children. However, not all children react to stimulants in a good way and thus the other drugs were kept as secondary options in case she did not react well to the drug in terms of side effects and how long those side effects persisted (Rosenberg et al., 2016).

Decision Two

When Katie came back for her follow-up, it was a case of good news and bad news. The side effects of Ritalin, the "heart fluttering" in this case, had gone away. Beyond that, the drug seemed to be effective. However, it has become clear that the drug is wearing off as the day progresses and she thus regresses to her prior usual self in the afternoon. Given that, this is why the decision was made to up the dose to 20 mg and to switch to a long-acting form. Ritalin is being stuck with because it is working but the formulation is being changed to long-acting so that she maintains a therapeutic effect and dose throughout the day. Her pulse and other measurements indicate that the drug is not negatively affecting her to the extent that a change in drug (e.g. to Bupropion or Intuiv) is necessary, at least for now (Hamedi et al., 2014).

Decision Three

The decision to stand pat at this point was the obvious one given that the therapeutic dose and affect is now sustained throughout the day and there is still no sign of symptoms or side effects that would suggest a drug change is in order. The results are good enough that an EKG is really not even needed or necessary given that there are no red flags that would suggest that checking her heart further would be needed (Paton et al., 2014).

Conclusion