NRNP 6665 Week 3 Assignment 1 Prescribing For Children and Adolescents Example Prescribing for Children and Adolescents
NRNP 6665 Week 3 Assignment 1 Prescribing For Children and Adolescents Example
Prescribing for Children and Adolescents
Separation Anxiety Disorder (SAD) is a developmental phenomenon; nonetheless, it manifests with excessive severity at a disproportionate age or in an inappropriate manner. SAD is characterized by great concern, worry, and even dread of separation from a close individual, whether actual or predicted (Feriante & Bernstein, 2020). Separation anxiety appears naturally between the ages of 6 and 12 months, persisting until around three and then lessening under normal conditions. The US Food and Drug Administration has not yet approved any drugs to treat Separation Anxiety Disorder.
Fluoxetine can be used as an off-label drug. Although some evidence supports using fluoxetine to treat separation Anxiety disorder, healthcare professionals should assess the medication’s potential advantages against its side effects (McNeil et al., 2022). This is based on the recommendations from consensus guidelines based on randomized controlled trials. Cognitive behavioral therapy is a non-drug treatment that I would suggest. It may help children learn how to deal with their anxiety better. The objective is also to assist a child in dealing with things that might make them anxious.
Numerous validated screening methods for childhood anxiety disorders are widely available. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) is what I would employ. The five subscale scores for the five most prevalent children’s anxiety disorders, SAD among them, make up the overall score. The SCARED evaluation instrument is considered a consistent, trustworthy, accurate, and sensitive indicator of anxiety. The SCARED screening tool has demonstrated strict invariance of measurements and test-retest solid reliability.
The use of fluoxetine has risks and benefits accompanying the off-label drug. Concerns about safety due to side effects (like an increased risk of suicidal thoughts or plans or lowered inhibitions that lead to aggression) prevent their use in pediatric populations right now unless the individual’s reaction is closely monitored or if the patient has responded well to SSRIs or SNRIs in the past (Bernstein, 2020). Except for fluoxetine, which seems to have an excellent risk-benefit ratio, the risks of giving SSRIs to children outweigh the benefits. Fluoxetine may hurt the gastrointestinal system more than other SSRIs. It should not be given to kids who are physically aggressive, whose families have a past of suicidal or parasuicidal thoughts or actions, or who are more likely to hurt themselves.
Current professional guidelines for treating SAD depend. If the symptoms are minimal, encouragement, support, and awareness may be enough to assist the patient in getting back to their regular routines. Maintaining consistent routines for eating, sleeping, and exercising while removing irregular ones should be encouraged. Validated screening techniques should be used to examine anxiety symptoms periodically to check for changes. Cognitive behavioral therapy is advised as the first-line therapy when treatment is necessary (Feriante & Bernstein, 2020; Silk et al., 2020).
There are no drugs with an FDA-labeled prescription for SAD, but selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed and proven effective at managing anxiety disorders (Ramsey et al., 2019). According to the American Academy of Child and Adolescent Psychiatry (AACAP), patients with separation anxiety aged 6 to 18 years old may benefit more from receiving combination treatment (CBT and an SSRI) than either CBT alone or an SSRI alone (Walter et al., 2020). Serotonin-norepinephrine reuptake inhibitors (SNRIs) may also be prescribed to patients with separation anxiety who are between the ages of 6 and 18.
References
Bernstein, B. E. (2020). Separation anxiety and school refusal medication: Tricyclic antidepressants, selective serotonin reuptake inhibitors, anxiolytic agents, antihistamines, beta-adrenergic blocking agents, anticonvulsants, alpha-adrenergic agents. Emedicine.medscape.com. https://emedicine.medscape.com/article/916737-medication#3
Feriante, J., & Bernstein,