NRNP-6665 Week 3: Assignment 1 – off label medications for bipolar disorder essay

NRNP-6665 Week 3: Assignment 1 – off label medications for bipolar disorder essay

Management of Bipolar Disorders in Children and Adolescents

Management of bipolar disorders in children is critical for ensuring that the underlying mood disorders are adequately and effectively addressed to enhance effective coping, maintain interpersonal relationships, work towards achieving the targeted academic growth, attain independence, and improve collaboration and coordination in the healthcare environment (American Psychiatric Association, 2013). Lithium is an FDA-approved agent for managing bipolar disorders in children. The drug is preferred because it is effective in stabilizing the mood by reducing the frequency and severity of manic episodes and depression. However, when using this agent, the child is at risk of developing problems such as impaired kidney and thyroid functions and resulting electrolyte disturbances such as sodium and lithium disturbances (Janiri et al., 2023). Therefore, monitoring the kidney, thyroid, and electrolyte functions is critical to achieving the targeted therapeutic functions.

On the other hand, Lamotrigine is commonly used as an off-label option for the management of bipolar disorders among children and adolescents. Research by Liu et al. (2022) indicates that lamotrigine is a non-FDA-approved agent for managing these disorders among children and adolescents. The drug is associated with the targeted therapeutic effects by enhancing the decreased frequency of depressive and manic episodes. Evaluation of the risks from lamotrigine should consider severe adverse and allergic effects such as Stevens-Johnson syndrome. Also, a higher risk for toxic epidermal necrolysis is seen in pediatric patients. Therefore, they need monitoring in the early phase of treatment to improve safety and for timely identification of the risks and problems involved. However, the patients also face some risks, and they include increased incidence of weight gain compared with other drugs. Hence, the nurse practitioner should compare the potential benefits against the possible risks to choose the right approach to include.

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Non-pharmacological Interventions

These conditions and mood stability may also be treated using non-pharmacological treatments such as psychotherapy. Such interventions may include psychoeducation or providing the child with more information about coping mechanisms and family-focused therapy to enhance the child’s ability to handle stressful mood dysfunctions (Gautam et al., 2019). The nurse practitioner has to ensure that the child’s caregivers, including the family members and teachers, acquaint themselves with the signals and preliminary actions to help the child learn coping strategies, which must be included in the care plan. Hence, there is a need to augment communication with the child and engage the family and the educational systems to support the implementation of care plans concerning the child. If so, the psychoeducation sessions may be designed at this frequency to facilitate the child’s developing better adaptation and coping with the issues and needs.

The Clinical Practice Guidelines

The Clinical Practice Guidelines (CPG), particularly for bipolar disorders and other mood conditions, are from the American Academy of Child and Adolescent Psychiatry, AACAP. The following guidelines require the PCP to undertake a Clinical assessment and evaluate the severity of the condition and the underlying needs to develop an individualized and effective management plan. The roles and responsibilities of the nurse practitioner include diagnosis and treatment through psychotherapy, administering medication, and psychotherapy because it is a prerequisite for the core and above-needed amount to be addressed (American Academy of Child and Adolescent Psychiatry, 2019). The nurse practitioner should also apply suitable personnel indicating relevant best practices and evaluate the origination of the child and family in a well-coordinated and timely management process.

The ethical and legal considerations of decision-making processes proposed by the nurse practitioner should consider the protection of pediatric patients, and their management for safety must be practical and sufficient. The nurse practitioner must involve the child’s family to ensure they obtain informed consent from the child. There is a need to take precautions by avoiding drug interaction with other diseases that may be affecting the child. Involving pediatric patients and thinking of how patients’ preferences can be incorporated into improving the quality of their care is also critical. This process needs proper and inevitably efficient cooperation with these stakeholders to promote the management of the root needs and create effective strategies and means for maximum results. Moreover, there should be good follow-up strategies to assess the effectiveness, tolerability, and adverse effects linked to the treatment plan provided.

 

References

American Academy of Child and Adolescent Psychiatry. (2019). Practice guidelines, updates and parameters. Aacap.org. https://www.aacap.org/AACAP/Resources_for_Primary_Care/Practice_Parameters_and_Resource_Centers/Practice_Parameters.aspx

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Pearson.

Gautam, S., Jain, A., Gautam, M., Gautam, A., & Jagawat, T. (2019). Clinical practice guidelines for bipolar affective disorder (BPAD) in children and adolescents. Indian Journal of Psychiatry, 61(8), 294. https://doi.org/10.4103/psychiatry.indianjpsychiatry_570_18

Janiri, D., Moccia, L., Montanari, S., Zani, V., Prinari, C., Monti, L., Chieffo, D., Mazza, M., Simonetti, A., Kotzalidis, G. D., & Janiri, L. (2023). Use of Lithium in Pediatric Bipolar Disorders and Externalizing Childhood- related disorders: A Systematic Review of Randomized Controlled Trials. Current Neuropharmacology, 21(6), 1329–1342. https://doi.org/10.2174/1570159×21666230126153105

Liu, L., Meng, M., Zhu, X., & Zhu, G. (2022). Research Status in Clinical Practice Regarding Pediatric and Adolescent Bipolar Disorders. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.882616  NRNP-6665 Week 3: Assignment 1 – off label medications for bipolar disorder essay