Off Label Drug Use in Pediatrics Essay

Off Label Drug Use in Pediatrics Essay

Therapy for Pediatric Clients with Mood Disorders
An African American Child Suffering From Depression

BACKGROUND INFORMATION
The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.
Client complained of feeling
Mother reports that teacher said child is withdrawn from peers in class  Mother notes decreased appetite and occasional periods of irritation Client reached all developmental landmarks at appropriate ages Drug Use in Pediatrics  Physical exam unremarkable
Laboratory studies WNL
Child referred to psychiatry for evaluation

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MENTAL STATUS EXAM
Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is . Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.
You administer the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)

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RESOURCES
§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

*Decision Point One
Begin Zoloft 25 mg orally daily
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
No change in depressive symptoms at all
*Decision Point Two
Increase dose to 50 mg orally daily.
RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks.
Depressive symptoms decrease by 50%. Client tolerating well.

*Decision Point Three

Maintain current dose.
Guidance to Student
At this point, sufficient symptom reduction has been achieved. This is considered a response to therapy. Can continue with current dose for additional 4 week to see if any further reductions in depressive symptoms are noted. An increase in dose may be warranted since this is not remission- Discuss pros/cons of increasing drug dose with client at this time and empower the client to be part of the decision. There is no indication that the drug therapy should be changed to an SNRI at this point as the client is clearly responding to this therapy.

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Write a 1-page narrative in APA format that addresses the following: Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Off Label Drug Use in Pediatrics Essay

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