Week 5 Dis

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Nursing

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Nov 24, 2024

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Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity that significantly impair daily functioning. Let’s delve into the risk-benefit analysis of using psychoactive drugs in children with ADHD, considering both accurate and inaccurate diagnoses. 1. The Natural Course of ADHD : o ADHD often persists into adolescence and adulthood, affecting academic performance, social relationships, and overall quality of life. o Without treatment, individuals with ADHD experience long- term negative outcomes across various domains, including academics, social function, and self-esteem 1 Links to an external site. . o Treatment aims to mitigate these impairments and enhance functionality. 2. Drug Action on Neurotransmitter Systems : o Commonly prescribed medications for ADHD include stimulants, for example, amphetamine, and non-stimulants (atomoxetine). o Stimulants primarily act on the dopamine and norepinephrine systems, enhancing attention, focus, and impulse control. o Non-stimulants, like atomoxetine, target norepinephrine reuptake inhibition. o These drugs help regulate neurotransmitter levels, improving symptoms. 3. Short-Term Benefits and Risks : o Positive Effects :  Improved attention, concentration, and academic performance.  Enhanced self-esteem and social interactions. o Negative Effects :  Stimulants : Potential side effects include insomnia, appetite suppression, and increased heart rate.  Non-stimulants : May cause drowsiness, nausea, or mood changes.  There is a risk of misuse or diversion, especially with stimulants. 4. Long-Term Benefits and Risks : o Positive Effects :

 Sustained symptom improvement.  Better educational and occupational outcomes. o Negative Effects :  Stimulants : Long-term safety is still debated, but no evidence suggests increased substance use disorder risk.  Non-stimulants : rare cases of liver toxicity.  Ethical concerns: balancing benefits with potential harm. 5. Permanent Effects : o Positive Effects :  Improved neural pathways related to attention and executive function. o Negative Effects :  None are specifically permanent; the risks are related to ongoing treatment. 6. Ethical Dimension : o Beneficence : Treating accurately diagnosed ADHD helps children function better. o Non-maleficence : Avoiding unnecessary treatment minimizes risks. o Ethical dilemmas arise when diagnosing and treating incorrectly, potentially exposing children to unnecessary drug effects. In summary, accurate diagnosis and appropriate treatment can significantly improve outcomes for children with ADHD. However, ethical considerations and potential risks must guide clinical decisions. Treating ADHD should be individualized, considering both short-term symptom relief and long-term well-being while minimizing harm. References Hechtman, L., Swanson, J.M., Sibley, M.H., et al. (2016). Functional adult outcomes 16 years after childhood diagnosis of attention-deficit/hyperactivity disorder: MTA results. J Am Acad Child Adolesc Psychiatry . 2016;55:945–952. Humphreys, K.L., Eng, T., and Lee, S.S. (2013). Stimulant medication and substance use outcomes: a meta-analysis. JAMA Psychiatry . 2013;70:740- 749.

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