Upon diagnosis, Katie presents Attentive deficit hyperactivity disorder (ADHD). Common among millions of children, ADHD is one of the most common entities seen by both children neurologists and psychiatrists. At its core, ADHD is a chronic condition that includes a combination of persistent problems such as impulsive behavior, hyperactivity, and difficulty in paying attention (Castells, Blanco-Silvente & Cunill, 2018). As a neurobehavioral syndrome defined by behavioral phenotype, ADHD frequently exists with other cognitive and behavioral disorders. Often ADHD continues to adulthood. While treatment cannot entirely cure ADHD, some medications, particularly stimulants, combined with behavioral interventions can make a big difference in the outcome.
For Katie’s case, the first decision was to administer Ritalin (methylphenidate) chewable tablets 10m early in the morning. The second step is to change to Ritalin LA 20m orally in the morning. The final decision was to maintain the current dose of Ritalin LA and do a reevaluation four weeks into the medication. The administration of Ritalin (methylphenidate) increased Katie’s heartbeat rate to 130 beats per minute. Additionally, her ADHD symptoms became better particularly in the morning, sequentially improving her academic performance. However, in the course of the day the symptoms recur. The change to Ritalin LA reduced Katie’s heartbeat to 92 per minute and further resulted in long-lasting attention throughout the day. The maintenance of Ritalin LA is advised at this stage. It can no longer be increased because low levels of stimulants are advised.
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Based on the impacts of the above medications on Katie, I would recommend that Katie remain on the Ritalin LA 20mg. In addition to a good treatment plan for ADHD, there should be close monitoring both at school and at home on how the treatment is impacting on the child’s behavior (Rosenthal & Burchum, 2018). Also, there should be regular check-ups about every three months to physically examine the child on side effects such as blood pressure and heart rate and a review of the child’s behavior to see whether the improvements are constant.
References
Castells, X., Blanco ‐ Silvente, L., & Cunill, R. (2018). Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews , (8).
Rosenthal, L., & Burchum, J. (2017). Lehne's Pharmacotherapeutics for Advanced Practice Providers-E-Book . Elsevier Health Sciences.
