Develop a differential diagnoses for the patient.

To prepare for this Discussion:
Note: To access the following case studies click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number. (Already attached with this posting)
Case 2: Volume 1 Case #14: The scatter-brained mother whose daughter has ADHD like mother like daughter
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation psychiatric history patient file medication history etc. As you progress through each section formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patients case history consider other people in his or her life that you would need to speak to or get feedback from (i.e. family members teachers nursing home aides etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this weeks Learning Resources for guidance.
Review the patients past and current medications. Refer to Stahls Prescribers Guide and consider medications you might select for this patient.
Review the posttest for the case study.
By Day 3
Post a response to the following:
Provide the case number in the subject line of the Discussion.
List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patients life you would need to speak to or get feedback from to further assess the patients situation. Include specific questions you might ask these people and why.
Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patients ADHD therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective provide a rationale for why you might choose one agent over the other.
If your assigned case includes check points (i.e. follow-up data at week 4 8 12 etc.) indicate any therapeutic changes that you might make based on the data provided.
Explain lessons learned from this case study including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.
Learning Resources
Note: To access this weeks required library resources please click on the link to the Course Readings List found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library the Stahl website will appear.
Clancy C.M. Change S. Slutsky J. & Fox S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence diagnosis and treatment. Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older.
Stahl S. M. (2013). Stahls essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York NY: Cambridge University Press.
To access the following chapters click on the Essential Psychopharmacology 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 12 Attention Deficit Hyperactivity Disorder and Its Treatment
Stahl S. M. & Mignon L. (2012). Stahls illustrated attention deficit hyperactivity disorder. New York NY: Cambridge University Press.
To access the following chapter click on the Illustrated Guides tab and then the ADHD tab.
Chapter 4 ADHD Treatments
Stahl S. M. (2014b). The prescribers guide (5th ed.). New York NY: Cambridge University Press.
To access information on the following medications click on The Prescribers Guide 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For ADHD
armodafinil
amphetamine (d)
amphetamine (dl)
atomoxetine
bupropion
chlorpromazine
clonidine
guanfacine
haloperidol
lisdexamfetamine
methylphenidate (d)
methylphenidate (dl)
modafinil
reboxetine
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: Author.
Optional Resources
Hodgkins P. Shaw M. McCarthy S. & Sallee F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs 26(3) 245268. doi:10.2165/11599630-000000000-00000
Psychiatric Times. (2016). A 5-question quiz on ADHD. Retrieved from http://www.psychiatrictimes.com/adhd/5-question-quiz-adhd?GUID=AA46068B-C6FF-4020-8933-087041A0B140&rememberme=1&ts=22072016
Course Texts
These course texts are available through Stahl Online Resources http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/
Stahl S. M. (2013). Stahls essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York NY: Cambridge University Press.
Stahl S. M. (2014b). The prescribers guide (5th ed.). New York NY: Cambridge University Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: Author.


 

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