Medication Treatment Schizophrenia Spectrum Study Guide

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yraev

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List five treatment options 

aripiprazole • chlorpromazine • haloperidol

quetiapine • risperidone. • olanzapine 

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1 Assessing and Treating Vulnerable Populations for Depressive Disorders Name Institution Course Date 2 Introduction Depressive disorders are mental health problems often characterized by consistently depressed mood and the frequent loss of interest in normal day-to-day activities. A depressed mood often leads to persistent sadness among patients, and different disorders affect patients. For this patient medication guide, I aim to explore depressive disorders among children. This condition affects children's behavior at home, with peers, and in school (Poznanski & Mokros, 1996). Causes and Symptoms The following factors often cause depressive disorders among children; first, stressful events such as changes at home such as parent divorce often increase the risk of children developing depressive disorders. The environment also plays a critical role in contributing to depressive disorders among children, as a chaotic and stressful home can put much pressure on a child (Watanabe et al., 2007). Due to family history, children with family members with a history of depressive disorders also tend to develop depressive disorders. Finally, children's physical health is important, as children with severe chronic conditions are more likely to develop depressive disorders. The symptoms of depressive disorders among children include; Sadness, Crying, Low energy, Communication problems, Suicidal thoughts, Guilt feeling, and Feelings of hopelessness (Ghandour et al., 2019). Diagnosis of depression among children The first step of diagnosing depressive disorders among children is by conducting a medical examination to evaluate cognitive processes (American Psychiatric Association, 2013). Lab tests may also be conducted to assist in ruling out certain disorders. The child's history and developmental history will be explored to assist in reviewing the kind of environment the child 3 resides in. furthermore, direct conversation with children can include open-ended questions to analyze their responses. Finally, children's relations with their parents or guardian will also be explored (Howland, 2008b). Children are considered a vulnerable population due to their high dependence on adults for basic needs. Therefore, denial of basic needs or abuse from adults could lead to depression among children. Therefore, most of the time, children would experience depressive disorders as a result of the actions of an adult, such as a parent or guardian (Howland, 2008a). Medication Treatment Option The approved medication for treating children with MDD include; Clomipramine, Fluoxetine, Sertraline, Escitalopram, and Fluvoxamine (Fava & Papakostas, 2016). The main side effect of these medications on children is that it increases suicidal thoughts among children. Parents and guardians are encouraged to closely monitor children taking these medications and seek immediate assistance from a healthcare professional if they feel the side effects are getting out of hand. The Food and Drug Administration is responsible for protecting the public by ensuring the safety of foods and drugs. Fluoxetine, also known as Prozac, is the only antidepressant approved by the FDA to treat depressive disorders among children (U.S. Food & Drug Administration, n.d.). Medication Consideration While diagnosing depressive disorders among children, Lab tests are essential, and healthcare professionals often monitor elements such as the complete blood count, cholesterol, and calcium and magnesium levels. Blood tests are vital as doctors use them to check for anemia, calcium, and vitamin D levels. Other disorders have similar symptoms as depressive disorders; doctors use lab tests to rule out these disorders. Monitoring lab tests is important because it offers an initial 4 assessment of depressive disorder among children and thus assists in determining possible treatment. Doctors will therefore monitor lab tests for depressive disorders among children to assist in gaining an overview of the extent of the disorder and thus understand what treatment would be recommended. Special Consideration a) Legal Consideration The main legal consideration for medication and treatment of depressive disorders among children is informed consent. Before administering medication such as Fluoxetine to children diagnosed with depressive disorders, a healthcare professional must first obtain informed consent from the legal guardians of the patients. The informed consent should also include a patient appraisal of the risk/benefit ratio. For instance, even though medications such as Fluoxetine have side effects, their benefits outweigh the risk. This is why it is FDA approved as a medication for children with depressive disorders (Lorberg et al., 2019). b) Ethical Consideration The ethical consideration in medication for depressive disorders includes voluntary participation, as children who undergo medication must participate voluntarily. Apart from informed consent, patients must participate voluntarily, ensuring they are not under duress or forced to do something they haven't approved. Another ethical consideration for medication for depressive disorders among children is confidentiality. There is a need to keep medication information private and only share it with legal guardians and parents. Confidentiality is essential because it assists in building trust between patients and healthcare professionals. Therefore, children suffering from depressive disorders can share more valuable and vital information by 5 ensuring confidentiality. Another ethical consideration on medication for depressive disorders is autonomy. Autonomy allows healthcare providers to educate patients or guardians but is prohibited from making decisions for the patient (Yasuda et al., 2008). c) Social determinants of health The social determinants are factors that people are accustomed to, including the physical environment, education, and neighborhood. However, children with depressive disorders are affected by poverty, inadequate access to healthcare, and poor environmental conditions. These are factors that can lead to depressive disorders among children. Therefore, by maintaining a good environmental condition, ensuring access to healthcare, and eradicating poverty, children may begin to overcome depression (Psych Hub, 2020). Follow up Location The local healthcare institution is the main place to conduct a follow-up in my community for further information. Therefore, whenever parents of a child diagnosed with depressive disorder have inquiries, they can visit the local hospital or book an appointment with the available healthcare professionals to seek further information (Mullen, 2018). Prescription writing Examples A prescription is an instruction written by healthcare professionals that offers a patient treatment plan. Different types of prescriptions exist, and each offers a different approach while writing a prescription for a patient (Magellan Health, 2013). 6 a) Simple Prescription These prescriptions have a single component or products and thus do not require admixture by a pharmacist. This prescription can be written by first including the patient's name, followed by the medication and the medication amount prescribed. The simple prescription offers the most basic format of writing a prescription. Fig 1. Simple prescription. b) Complex Prescription Complex prescriptions are those written for more than one component. The following information is therefore included when writing a complex prescription; patient name, date of birth, patient phone number, active drug name, dosage, and direction of usage. c) In-patient Prescription This is a medication order used majorly in the hospital setting. These can be drug-specific forms for patients relocating from one department to another. Writing these prescriptions involves including a patient's name and medication, as other information is readily available in the hospital database. 7 Conclusion Depressive disorders are common among children just as they are in adults. The causes and symptoms are similar because children are exposed to stressful events such as divorcing parents or poor living conditions. However, children's environment also plays a critical role in influencing depressive disorders. For instance, if the child is being bullied in school, they will be depressed. The diagnosis process for children with depressive disorders primarily includes doctor-patient interaction, and the healthcare professional might conduct lab tests to rule out certain diagnoses. The main medication offered to children suffering from depressive disorders is Fluoxetine, an FDA-approved medication. However, parents and legal guardians have to be aware of the side effects, and this information must be provided through informed consent, and healthcare professionals also have to guarantee voluntary participation and autonomy. While offering medication to patients, healthcare professionals are encouraged to use prescriptions that offer detailed information on how patients must utilize their medication (Baek et al., 2016). 8 References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Baek, J. H., Nierenberg, A. A., & Fava, M. (2016). Pharmacological approaches to treatmentresistant depression. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 44–47). Elsevier. Fava, M., & Papakostas, G. I. (2016). Antidepressants. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 27–43). Elsevier. Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (2019). Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of pediatrics, 206, 256–267. Howland, R. H. (2008a). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24. https://doi.org/10.3928/02793695-20080901-06 Howland, R. H. (2008b). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services, 46(10), 21–24. https://doi.org/10.3928/02793695-20081001-05 Lorberg, B., Davico, C., Martsenkovskyi, D., & Vitiello, B. (2019). Principles in using psychotropic medication in children and adolescents. In J. M. Rey & A. Martin (Eds.), 9 IACAPAP e-textbook of child and adolescent mental health. https://iacapap.org/_Resources/Persistent/a97650fb538f47bb697c47 873b0e58d493684a07/A.7-Psychopharmacology-2019.1.pdf Magellan Health. (2013). appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. http://www.magellanhealth.com/media/445492/magellanpsychotropicdrugs-0203141.pdf Mullen, S. (2018). Major depressive disorder in children and adolescents. Mental Health Clinician, 8(6), 275–283. Poznanski, E. O., & Mokros, H. B. (1996). Child depression rating scale—Revised. Western Psychological Services. Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. https://doi.org/10.1002/da.22171 Psych Hub. (2020). Social determinants of health [Video]. YouTube. https://www.youtube.com/watch?v=17jeXGbKlTQ U.S. Food & Drug Administration. (n.d.). Fluoxetine (marketed as Prozac) Information. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-andproviders/fluoxetine-marketed-prozac-information Watanabe, N., Hunot, V., Omori, I. M., Churchill, R., & Furukawa, T. A. (2007). Psychotherapy for depression among children and adolescents: a systematic review. Acta Psychiatrica Scandinavica, 116(2), 84–95. Yasuda, S. U., Zhang, L. & Huang, S.-M. (2008). the role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 10 84(3), 417–423. https://web.archive.org/web/20170809004704/https://www.fda.gov/do wnloads/Drugs/ScienceResearch/.../UCM085502.pdf
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Medications Guide for Schizophrenia Spectrum

Name
Institution
Course
Professor
Date

2
Medications Guide for Schizophrenia Spectrum
1. Description
Brand Name

Generic
Name

FDA-approved Indications

Abilify, Abilify
Maintena,
Aristada

Aripiprazole

Schizophrenia, acute manic and mixed episodes for bipolar
I disorder, major depressive disorder, autistic disorder

Chlorpromazine

Thorazine

Schizophrenia, nausea and vomiting, porphyria, tetanus,
manic & manic-depressive symptoms

Haldol

Haloperidol

Schizophrenia, Tourette’s disorder, psychotic disorder
manifestations, combative behavioral problems and
hyperexcitability in children

Seroquel

Quetiapine
fumarate

Schizophrenia, bipolar disorder, Major Depressive
Disorder

Risperdal,
Risperidone
Risperdal Consta

Schizophrenia, bipolar disorder, irritability caused by
autistic disorder (FDA, n.d.)

2. Non-FDA Uses
Drug

Off-Label Use and Level of Evidence

Abilify

Anxiety, ADHD, Dementia, eating disorders, insomnia, OCD, PTSD

Chlorpromazine

Anxiety, delirium, insomnia, pain management, intractable hiccups

Haldol

Delirium, insomnia, intractable hiccups

Seroquel

Anxiety, dementia, OCD, psychosis in Parkinson’s disease

Risperdal

Anxiety, ADHD, dementia, depression, OCD, personality disorder

Key
Green- High level of evidence
Blue- Moderate to high level
Red- Low or no evidence

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3. Drug Classification
First Generation Antipsychotics

Chlorpromazine, Haldol

Second Generation Antipsychotics

Abilify, Seroquel, Risperdal

4. Medication Mechanism of Action
The exact mechanism of action for antipsychotics is unclear. However, all antipsychotics are
hypothesized to antagonize the neurotransmission of dopamine through post-synaptic D2
dopamine receptors blockage (Grinchii & Dremencov, 2020). This mechanism is illustrated in
figure 1 below...

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