PANIC DISORDER

Assignment 1: Prescribing for Children and Adolescents

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

Photo Credit: Getty Images/Ingram Publishing

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Reference:

Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html

To Prepare

  • Your Instructor will assign a specific disorder for you to research for this Assignment.
  • Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

The Assignment (1–2 pages)

  • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
  • Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
  • Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
  • Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

Reminders for WEEK 3:

  • Required Readings & Media
  • Assignment 1: Prescribing for Children and Adolescents
    • Research evidence-based treatments for your assigned disorder in children and adolescents.

 

        • H-S: Panic Disorder

 

    • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
    • Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
    • Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
    • Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.
  • In 1–2 pages, address the following: 

    Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.

  • Excellent 23 (23%)- 25 (25%)
  • The response accurately and concisely explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.
  • Good 20 (20%)- 22 (22%)
  • The response accurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.
  • Fair 18 (18%)- 19 (19%)
  • The response somewhat vaguely or inaccurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.
  • Poor 0 (0%)- 17 (17%)
  • The response vaguely or inaccurately explains interventions that would be appropriate for treating the assigned disorder in children and adolescents. Interventions may not represent the three types of interventions required, or response may be missing.
  • Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
  • Excellent 23 (23%)- 25 (25%)
  • The response accurately and concisely explains the risk assessment you would use to inform your treatment decision making. A concise and accurate explanation of the risks and benefits of each pharmacological intervention is provided.
  • Good 20 (20%)- 22 (22%)
  • The response accurately explains the risk assessment you would use to inform your treatment decision making. An adequate explanation of the risks and benefits of each pharmacological intervention is provided.
  • Fair 18 (18%)- 19 (19%)
  • The response somewhat vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The explanation of the risks and benefits of each pharmacological intervention is somewhat vague or inaccurate.
  • Poor 0 (0%)- 17 (17%)
  • The response vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The risks and benefits of each pharmacological intervention is vague or inaccurate. Or, the response is missing.
  • Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
  • Excellent 23 (23%)- 25 (25%)
  • The response accurately and concisely uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.
  • Good 20 (20%)- 22 (22%)
  • The response accurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.
  • Fair 18 (18%)- 19 (19%)
  • The response somewhat vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.
  • Poor 0 (0%)- 17 (17%)
  • The response vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. Or, the response is missing.
  • Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Be sure they are current (no more than 5 years old). Attach the PDFs of your sources.
  • Excellent 9 (9%)- 10 (10%)
  • The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations. The resources reflect the latest clinical guidelines and provide strong justification for decision making.
  • Good 8 (8%)- 8 (8%)
  • The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations.
  • Fair 7 (7%)- 7 (7%)
  • Three evidence-based resources are provided to support the intervention recommendations, but they may only provide vague or weak justification.
  • Poor 0 (0%)- 6 (6%)
  • Two or fewer resources are provided to support the intervention recommendations. The resources may not be current or evidence based.
  • Written Expression and Formatting – Paragraph Development and Organization: 

    Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

  • Excellent 5 (5%)- 5 (5%)
  • Paragraphs and sentences follow writing standards for flow, continuity, and clarity.A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
  • Good 4 (4%)- 4 (4%)
  • Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
  • Fair 5 (3.5%)- 3.5 (3.5%)
  • Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.Purpose, introduction, and conclusion of the assignment are vague or off topic.
  • Poor 0 (0%)- 3 (3%)
  • Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time.No purpose statement, introduction, or conclusion were provided.
  • Written Expression and Formatting – English Writing Standards: 

    Correct grammar, mechanics, and proper punctuation

  • Excellent 5 (5%)- 5 (5%)
  • Uses correct grammar, spelling, and punctuation with no errors
  • Good 4 (4%)- 4 (4%)
  • Contains one or two grammar, spelling, and punctuation errors
  • Fair 5 (3.5%)- 3.5 (3.5%)
  • Contains several (three or four) grammar, spelling, and punctuation errors
  • Poor 0 (0%)- 3 (3%)
  • Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
  • Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.
  • Excellent 5 (5%)- 5 (5%)
  • Uses correct APA format with no errors
  • Good 4 (4%)- 4 (4%)
  • Contains one or two APA format errors
  • Fair 5 (3.5%)- 3.5 (3.5%)
  • Contains several (three or four) APA format errors
  • Poor 0 (0%)- 3 (3%)
  • Contains many (five or more) APA format errors
Total Points: 100

Learning Resources

Required Readings (click to expand/reduce)

 

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

 

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

  • Chapter 43, “Pharmacological, Medically-Led and Related Treatments”

Walden University. (n.d.). Developing SMART goals. https://academicguides.waldenu.edu/ld.php?content_id=51901492

 

 

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

  • Chapter 5, “Psychopharmacology”

 

 

Learning Resources

Required Readings (click to expand/reduce)

 

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

 

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

  • Chapter 43, “Pharmacological, Medically-Led and Related Treatments”

Walden University. (n.d.). Developing SMART goals. https://academicguides.waldenu.edu/ld.php?content_id=51901492

 

 

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

  • Chapter 5, “Psychopharmacology”

Required Media (click to expand/reduce)

 

CriticalThinkRx. (2019, June 9). Module 5: Specific drug classes: Focus on adverse effects [Video]. YouTube. https://youtu.be/Gbq6RnOsGKQ

CriticalThinkRx. (2019, June 9). Module 2: Use of psychotropics with youth_prevalence and concerns [Video]. YouTube. https://youtu.be/NRef-g4Ding

 

 

 

 

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