Assignment 2

Reading resources for Assignment 2 off-label drugs

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

· Chapter 8, “Drug Therapy in Pediatric Patients” (pp. 65—67)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557722/

https://www-ncbi-nlm-nih-gov.ezp.waldenulibrary.org/pmc/articles/PMC5736254/

http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_02/index.html

THE SCENARIO

An African American Child Suffering From Depression

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 50mg orally daily

RESULTS OF DECISION POINT TWO

·  Client returns to clinic in four weeks

·  Depressive symptoms decrease by 50%. Cleint 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 “full” 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.