Assessing and Treating Pediatric Patients with Mood Disorders

Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
I want you to answer the questions given to you (decision points one, two, and three) before you click on the option. The answers will be based on your decisions made and patient outcomes during the decision tree. The course page suggests writing 1 page per decision – my opinion is that it will be very difficult to justify your treatment decisions and provide scientific evidence in 1 page (especially for decision #1). I would consider the “5 pages” stated in the classroom to be the absolute minimum for these assignments. Please don’t provide an overview of subjective or objective patient info from the cases – I am very familiar with them already. Your introductory page should be an overview of the disease state you are treating along with a purpose statement for the assignment. Remember this is a Pharmacology class and your decision tree should be reflective of exactly that, an emphasis on pharmacology, not diagnostics/assessment. I want you to tell me why you selected an option - why is it the best option, using clinically relevant data from primary literature (clinical trials, treatment guidelines) and patient specific data AND why you did not choose the other options (with clinically relevant data from primary literature and patient specific data). As you write this case up, I want you to imagine defending yourself on the witness stand in a medical malpractice case or in front of a group of attending physicians, residents and fellows in Grand Rounds. This is the level of detail and evidence from scientific sources you should be providing. Describing that a drug is FDA approved, it’s mechanism of action, bioavailability, pharmacokinetics, etc. would not stand up as “evidence” in these instances, nor will it suffice for the purposes of this course. I want you to summarize specific data from clinical trials, treatment guidelines, case reports, meta analyses, etc. that demonstrates why you feel the drug you’ve selected is the safest and most effective for the patient. You will also need to do the same for the drugs you did not pick – summarize the data that led you to believe these therapies were suboptimal choices.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy.
The Assignment
Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
Introduction to the case (1 page)
Briefly explain and summarize the disease state you are treating this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
At each decision point stop to complete the following:
Decision #1 (1.5+ pages)
Which decision did you select?
Why did you select this decision? Support your response with strong scientific evidence discussing efficacy, safety, tolerability and patient outcomes from primary literature (not information from Micromedex, Epocrates or UpToDate) and references. Why did you NOT select the other treatment options available? Again, provide STRONG scientific evidence from the primary literature. Clinical studies or treatment guidelines are a good place to start!
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
What ethical considerations impacted your treatment plan and communication plan with the patient?
Decision #2 (1+ pages)
Which decision did you select?
Why did you select this decision? Support your response with strong scientific evidence discussing efficacy, safety, tolerability and patient outcomes from primary literature (not information from Micromedex, Epocrates or UpToDate) and references. Why did you NOT select the other treatment options available? Again, provide STRONG scientific evidence from the primary literature. Clinical studies or treatment guidelines are a good place to start!
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
What ethical considerations impacted your treatment plan and communication plan with the patient?
Decision #3 (1+ pages)
Which decision did you select?
Why did you select this decision? Support your response with strong scientific evidence discussing efficacy, safety, tolerability and patient outcomes from primary literature (not information from Micromedex, Epocrates or UpToDate) and references. Why did you NOT select the other treatment options available? Again, provide STRONG scientific evidence from the primary literature. Clinical studies or treatment guidelines are a good place to start!
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
What ethical considerations impacted your treatment plan and communication plan with the patient?
Conclusion (1 page)
Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. You should provide new data here – not a repeat of the data you used previously in the paper.
After writing up your rationale at each decision point, I would ask yourself the following questions:
Have I provided clinical data from a meta-analysis, case report or clinical trial to support the drug I picked being safe, efficacious and the best choice for this patient? If the answer is NO, you’ll want to start over
Have I provided clinical data, etc. to support a clear rationale as to why the other treatment options are NOT optimal? If the answer is NO, you’ll want to start over
Is the focus of my discussion on mechanism of action and receptors/neurotransmitters that the drug acts on? If the answer is YES, you should consider doing additional research to address the above two questions