READ BELOW:
1.
1. chose Atomoxetine for this patient.
2. List medication class and mechanism of action for the chosen medication.
1. According to Stahl (2021), this drug is a norepinephrine reuptake inhibitor and a selective norepinephrine inhibitor. Atomoxetine boosts norepinephrine/noradrenaline and increased dopamine in the prefrontal cortex. It also blocks norepinephrine reuptake pumps. Atomoxetine will also increase dopamine in the frontal cortex.
3. Write the prescription in prescription format.
1. Patient Name: John Doe
2. DOB: 01/01/2015
3. Date: 02/14/2024
4. Medication: Atomoxetine 25mg capsule
5. SIG: Take 1 capsule by mouth once per day
6. Dispense: #7 capsules
7. Refills:0
8. Prescriber: Ricky Hem
9. License Number:123456789
10. DEA number:123456789
4. Provide an evidence-based rationale for the selected medication using at least one scholarly reference. Textbooks may be used for additional references but are not the primary reference.
1. The reason that I chose this drug as opposed to a stimulant was because of the patient’s auditory hallucinations. That being said, I chose atomoxetine because it’s generally the first non-stimulant drug for ADHD in children and adults (Fu, 2023). In another study done by Ruppert (2022), atomoxetine “showed a significantly stronger effect in terms of symptom reduction and improvement of functional abilities in children and adolescents with ADHD.”
5. List any side effects or adverse effects associated with the medication.
1. Side effects include sedation, fatigue, decreased appetite, rare priapism, increased heart rate, increased blood pressure, insomnia, dizziness, anxiety, agitation, aggression, irritability, dry mouth, constipation, nausea, vomiting, abdominal pain, dyspepsia, urinary hesitancy, urinary retention, dysmenorrhea, sweating, sexual dysfunction. Life threatening adverse effects include increased heart rate or hypertension, orthostatic hypotension, severe liver damage, hypomania, rare induction of mania, rare activation of suicidal ideation and behavior (Stahl, 2021).
6. Include any required diagnostic testing. State the time frame for this testing (testing is before medication initiation or q 3 months, etc.). Includes normal results range for any listed laboratory tests.
1. According to Stahl (2021), there is no need to test for healthy patients – but monitoring blood pressure and pulse for is recommended until dose increments have stabilized. Normal HR for him would be 70-110, and normal SBP/DBP would be 100-120 and 60-75, respectively.
7. Provide a minimum of three appropriate medication-related teaching points for the client and/or family.
1. I would still warn the mother regarding rare activation of mania since the patient was already having auditory hallucinations prior – it is important to decipher whether or not this is an imaginary friend at young ages versus actual auditory hallucinations.
2. I would also warn the mother and patient about being fatigue and its sedative effects – if this is the case, we could possibly switch this to be taken at night especially since the patient was already having trouble sleeping, this might be more beneficial.
3. The last point would be to schedule weekly face-to-face visits until the medication has been titrated to the standard dose from the initial dosing so we can monitor side effects closely.
INSTRUCTIONS:
a. Engage to what you’ve read above by asking questions, and offering new insights, applications, perspectives, information, or implications for practice. Engage by agreeing with the choice of medication. Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.
Use current 7th edition APA format to format citations and references and is free of errors. References within 5 years 1 paragraph.
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