ADHD

What is ADHD?

The National Institute of Mental Health defines Attention-deficit/hyperactivity disorder (ADHD) as a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

Who is at risk?

The same Institute discusses possible factors that could influence ADHD, including:

• Genes
• Cigarette smoking, alcohol use, or drug use during pregnancy
• Exposure to environmental toxins during pregnancy
• Exposure to environmental toxins, such as high levels of lead, at a young age
• Low birth weight
• Brain injuries

What is the recommended treatment for children with ADHD?

The recommended first-line of treatment for children with attention-deficit/hyperactivity disorder (ADHD) is methylphenidate according to the clinical practice guideline created by the American Academy of Pediatrics (AAP, 2017).  The recommended starting dose of methylphenidate for children ages 6-12 years old is 18mg a day available in extended-release tablets (Woo & Robinson, 2016).  Additionally, several studies suggest that the use of a diet rich in omega-3 fatty acids in children with ADHD is effective and cost-efficient.

Any additional interventions?

Children with ADHD can benefit from a prescribed diet, drug administration, and behavior therapy. Behavior therapy includes modifications in school environment, school programs, or modifications such as assigned seating, work assignments, and test modifications (CDC, 2017). 

Are APRNs certified to prescribe this medication?

In Florida, the psychiatric nurse is the only advanced practice nurse (APRN) that has the authority to prescribe Schedule II controlled substances for patients younger than 18 years old (H.R. 423, 2016). 

References

Attention Deficit Hyperactivity Disorder. (2016). Retrieved from 

          https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-

          adhd/index.shtml

Bhat, V., & Hechtman, L. (2016). Considerations in selecting pharmacological treatments for

           attention deficit hyperactivity disorder. Clinical Pharmacist, 8(2). 

           doi:10.1211/cp.2016.20200602

            Retrieved from https://www.cdc.gov/ncbddd/adhd/guidelines.html

Centers for Disease Control and Prevention. (2017). Attention-Deficit / Hyperactivity Disorder 

             (ADHD).

Florida HB 423 – ARNP/PA Controlled Substance Prescribing. (n.d.). Retrieved from 

               http://fana.org/florida-hb-423-arnppa-controlled-substance-prescribing/   

Woo, TM., Robinson, MV. (2016). Pharmacotherapeutics for advanced practice nurse prescribers 

               (4th ed.). FA Davis Co. Philadelphia