Support or expand on your original argument to refute their claims.
your response needs to be supported by two (2) scholarly peer-reviewed resources located outside of your course Learning Resources.
Response to Rakesh:
Patient 1, who is also referred to as Malcolm, and scrutinize the complexities of each potential option. An analysis of Amphetamine-Based Medications, Methylphenidate-Based Medications, and Alpha Adrenergic Medications.
An analysis of the differences between agonists and non-stimulant medications:
Proposed Mechanism of Action and Pharmaceuticals that include amphetamines:
Medications, such as Adderall, work by increasing the levels of dopamine and norepinephrine in the brain. Participating in this exercise enhances individuals’ capacity to focus, maintain attention, and control impulsive behavior, which is often impaired in those with ADHD (Nieddu et al., 2022).
Medications containing methylphenidate:
Medications like Ritalin function by elevating the concentrations of dopamine and norepinephrine in the brain, therefore improving concentration and reducing hyperactivity and impulsivity.
Alpha adrenergic agonists:
Intuniv (guanfacine), an alpha adrenergic agonist, specifically targets receptors in the brain to control the levels of norepinephrine. This approach has the capacity to improve focus and control impulsive behavior in individuals diagnosed with ADHD.
Non-stimulant pharmaceuticals:
Strattera, a non-stimulant medicine, specifically affects different neurotransmitters, including norepinephrine. It provides an alternate treatment option for individuals who may have challenges in tolerating stimulant treatments (Nieddu et al., 2022).
Advantages and Disadvantages: Medications Based on Amphetamines:
Advantages
These medications often have a fast onset of effects, allowing for immediate relief of symptoms. They are available in many formulations, including extended-release versions, which may deliver sustained effects throughout the course of the day.
Disadvantages:
Amphetamine-based medications has the capacity to be misused and redirected. Some individuals may have potential side effects such as insomnia, decreased appetite, and changes in mood.
Medications containing methylphenidate
Advantages:
Methylphenidate medications are generally well-tolerated by a substantial proportion of individuals. Extended-release formulations provide a longer period of time for managing symptoms (Krough et al., 2024).
Disadvantages
Patients may need to receive many doses throughout the day, and possible side effects such as decreased appetite and disturbances in sleep patterns may occur.
Advantages of Alpha Adrenergic Agonists:
These non-stimulant options are suitable for anyone who cannot tolerate or have concerns about utilizing stimulant medications. They may help alleviate ADHD symptoms without the possible risks associated with stimulant drugs.
Some individuals may have adverse symptoms such as fatigue, vertigo, and hypotension.
Non-stimulant pharmaceuticals
Advantages:
Non-stimulant pharmaceuticals like Strattera are non-addictive and may be the preferred choice for those who do not respond well to stimulant drugs or have a history of substance abuse.
Disadvantages
These medications often have a slower onset of action compared to stimulants, therefore it is crucial to exercise patience in order to fully benefit from their therapeutic benefits.
Adverse Effects and Factors to Consider:
Common side effects seen in these classes of drugs include insomnia, decreased appetite, gastrointestinal distress, and changes in mood (Krough et al., 2024). It is crucial to properly observe and evaluate the efficacy and any negative consequences of these medications since individual responses may differ. When initiating ADHD medication, it is essential to consider considerations such as dose adjustment, potential drug interactions, and diligent monitoring for any cardiovascular complications.
Implications pertaining to legal, ethical, and societal issues
Strict adherence to regulations is necessary when prescribing illegal drugs, such as amphetamines, in order to prevent misuse, unauthorized distribution, and ensure the safety of patients (Krough et al., 2024).
Healthcare practitioners must give priority to the patient’s welfare, get informed consent, and navigate the ethical complexities of providing psychiatric medications (Krough et al., 2024).
Confronting the bad impression around ADHD and its treatment is crucial. Disseminating knowledge about ADHD and its management to patients, families, and the community aids in enhancing understanding and support.
In order to choose the appropriate medication for Malcolm, it is essential to do a comprehensive evaluation of his symptoms, medical history, past treatment results (if applicable), and unique needs. Engaging in collaborative decision-making with healthcare specialists, parents, and Malcolm himself is crucial to tailor a treatment approach that maximizes benefits while minimizing downsides. Consistent and ongoing monitoring are essential components of successful ADHD treatment in children, such as Malcolm.
Patient 2
Let’s elaborate on the comparison of several pharmacological categories for treating ADHD in the case of Jessica, a recently diagnosed 32-year-old lady.
The method by which Amphetamine Adderall exerts its effects is currently being discussed.
Amphetamines enhance the release of neurotransmitters, namely dopamine and norepinephrine, inside the brain. Consequently, there is an improvement in focus, mindfulness, and the capacity to control impulsive behavior.
Advantages
Amphetamines quickly start its effects, leading to a fast reduction in symptoms. These formulations come in several types, including immediate-release and extended-release, which allows for flexibility in dose. In addition, many formulations provide the benefit of once-daily dosing, which enhances convenience.
Disadvantages
Amphetamines provide a potential hazard of abuse and addiction. Common side effects include insomnia, decreased appetite, weight loss, and increased heart rate.
Methylphenidate, often referred to as Ritalin, functions via a distinct method of action.
Methylphenidate increases dopamine and norepinephrine levels in the brain by preventing their reabsorption (Krough et al., 2024). This method intensifies the effect of neurotransmitters, hence improving attention and focus
Advantages
Methylphenidate is a commonly prescribed medicine for ADHD and is available in several formulations, such as immediate-release and extended-release, to cater to personalized treatment approaches (Levrini, 2024). Patients often exhibit a significant amount of tolerance for it.
Disadvantages
Methylphenidate, similar to amphetamines, has a propensity for misuse. Potential side effects may include insomnia, decreased appetite, and potential growth suppression in young patients.
Alpha adrenergic agonists Clonidine and Guanfacine
The mode of operation of alpha adrenergic agonists is to selectively target and activate alpha-adrenergic receptors in the brain. These receptors are responsible for regulating certain pathways of neurotransmitters that are related with attention and impulse control (Levrini, 2024)..
Advantages
These medications provide an option for those who do not have a favorable reaction to stimulants or have concerns about the possibility of overuse. They may be particularly beneficial for those who have concurrent conditions such as tics or anxiety (Levrini, 2024).
Disadvantages
Alpha adrenergic agonists have a slower onset of their effects as compared to stimulants. Common side effects include drowsiness, dizziness, and low blood pressure.
Non-stimulating alternative options
The mechanism of action of atomoxetine
Atomoxetine, a non-stimulant medication, works by inhibiting the uptake of norepinephrine in the brain. This activity elevates the levels of norepinephrine, resulting in improved attention regulation.
Advantages
Non-stimulant options, which are not habit-forming, may be more appropriate for those with a prior history of substance abuse. They are also suitable for those who do not have a positive reaction to stimulant medications (Levrini, 2024).
Disadvantages
Non-stimulant medications often have a longer onset time for their effects as compared to stimulant medications. While generally well-tolerated, there is a potential for suffering side effects such as stomach discomfort, fatigue, and a likely elevation of liver enzymes (Bannette et al, 2024).
Possible negative responses and factors to take into account (Side effects).
In addition to the previously mentioned common side effects, it is important to monitor for any changes in mood, cardiovascular effects (such as increased heart rate and blood pressure), and growth in pediatric patients. Due to potential variances in individual medication responses, it is important for healthcare professionals to thoroughly assess and modify the treatment plan as necessary (Bannette et al, 2024).
Implications with legal, ethical, and social ramifications
Prescribing controlled drugs, such as stimulant medications, requires adherence to regulations and careful oversight to avoid misuse or unauthorized distribution (Seymour et al., 2023).
When healthcare practitioners engage in discussions about treatment options and potential risks with patients, they should prioritize patient autonomy, informed consent, and confidentiality.
Confronting and overcoming negative attitudes and ideas related to ADHD and the use of medication is of utmost importance (Seymour et al., 2023).
Providing information and support to patients and their families may enhance understanding and acceptance in many social contexts.
To determine the most appropriate medication for Jessica, it is crucial for her to undergo a comprehensive assessment by a healthcare specialist who specializes in treating ADHD. This examination will include her individual needs, preferences, and medical history. By using collaborative decision-making, ongoing evaluation, and the support of a multidisciplinary team, we can improve treatment outcomes and increase Jessica’s quality of life (Seymour et al., 2023).
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