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Assignment: off-label drug use in pediatrics | NURS 6521 – Advanced Pharmacology | Walden University

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 PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW

1). ZERO (0) PLAGIARISM

2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS (WITHIN 5YRS, OR LESS THAN 5YRS)

3).  PLEASE SEE THE ATTACHMENT FOR RUBRIC DETAILS AND RECOMMENDED WRITING TEMPLATE AND APA 7 STYLE.

4). Please review and follow the grading rubric details, and include each component in the assignment as required. Also, follow the APA writing rules and style, Title page, summary, Conclusion, References. 

5) Please, Include the Title page, Introduction, purpose statement, Literature Review, conclusion, and reference page. 

Thank you very much.  

 

 

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.  

 Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of the safety implications of the off-label use of drugs with this patient group.

To Prepare
  • Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
  • Reflect on situations in which children should be prescribed drugs for off-label use.
  • Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

 

Write a 1-page narrative in APA format that addresses the following:

  • Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
  • Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

African American Child

BACKGROUND INFORMATION

The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.

  • Client complained of feeling “sad”
  • Mother reports that teacher said child is withdrawn from peers in class
  • Mother notes decreased appetite and occasional periods of irritation
  • Client reached all developmental landmarks at appropriate ages
  • Physical exam unremarkable
  • Laboratory studies WNL
  • Child referred to psychiatry for evaluation

MENTAL STATUS EXAM

Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.

You administer the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)

RESOURCES

§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

PLEASE NOTE BELOW:  

I have provided all the decision points about the drugs. Decisions point one is to pick one medication to begin, either Zoloft, Paxil, or Wellbutrin. I provided all decision points under each drug to follow if any changes are to be made. 

For Zoloft:

  Decision Point One

Begin Zoloft 25 mg orally daily

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • No change in depressive symptoms at all

Decision Point Two

Increase dose to Zoloft 50 mg orally daily

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Depressive symptoms decrease by 50%. Client tolerating well

Decision Point Three

Maintain current dose

Guidance to Student
At this point, sufficient symptom reduction has been achieved. This is considered a “response” to therapy. Can continue with current dose for additional 4 week to see if any further reductions in depressive symptoms are noted. An increase in dose may be warranted since this is not “full” remission- Discuss pros/cons of increasing drug dose with client at this time and empower the client to be part of the decision. There is no indication that the drug therapy should be changed to an SNRI at this point as the client is clearly responding to this therapy.

For Paxil:

 
Decision Point One

Begin Paxil 10 mg orally daily

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Reduction in The Children’s Depression Rating Scale by 5 points overall, but with complaints of nausea, vomiting, and diarrhea

Decision Point Two

Change to Prozac 10 mg orally daily

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • There is a 25% reduction in symptoms, client’s side effects of nausea, vomiting, and diarrhea have resolved. Client reports that he is feeling a “little bit better”

Decision Point Three

Continue current dose

Guidance to Student
You have two equally compelling choices at this point. The client has only been taking the current drug at its current dose for 4 weeks. It would be appropriate to continue at current dose. Additionally, you could also increase the dose to 20 mg orally daily. A discussion of risk/benefits should be had with the childs guardian regarding this and collaborative decision making should occur. There is no indication at this point that augmentation agents are required as the child is showing a partial response to therapy.

For  Wellbutrin:

Decision Point One

Begin Wellbutrin 75 mg orally BID

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Child is unable to fall asleep at night

 

 

 Decision Point Two

Change to Lexapro 10 mg orally daily

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Child is tolerating Lexapro, and is sleeping at night. There is a 40% reduction in symptoms

 Decision Point Three

Continue current dose

Guidance to Student
At this point, there is no indicating that you should change back to Wellbutrin as the child is tolerating the current medication without mention of side effects. Also, the child is experiencing a reduction in symptoms. You could also increase the dose to 15 mg orally daily, but the child has only been taking the drug for 4 weeks at this point. It may be more prudent to give the current therapy an additional 4 weeks before making any decisions to change current dose.

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July 1, 2023
    

 

101. On January 1, a company issued and sold a $400,000, 7%, 10-year bond payable, and received proceeds of $396,000. Interest is payable each June 30 and December 31. The company uses the straight-line method to amortize the discount. The journal entry to record the first interest payment is: 

A. Debit Bond Interest Expense $14,000; credit Cash $14,000.

B. Debit Bond Interest Expense $28,000; credit Cash $28,000.

C. Debit Bond Interest Expense $14,200; credit Cash $14,000; credit Discount on Bonds Payable $200.

D. Debit Bond Interest Expense $13,800; debit Discount on Bonds Payable $200; credit Cash $14,000.

E. Debit Bond Interest Expense $14,000; debit Discount on Bonds Payable $200; credit Cash $14,200.

102. A company issued 5-year, 7% bonds with a par value of $100,000. The company received $97,947 for the bonds. Using the straight-line method, the amount of interest expense for the first semiannual interest period is: 

A. $3,294.70.

B. $3,500.00.

C. $3,705.30.

D. $7,000.00.

E. $7,410.60.

103. The effective interest amortization method: 

A. Allocates bond interest expense over the bond's life using a changing interest rate.

B. Allocates bond interest expense over the bond's life using a constant interest rate.

C. Allocates a decreasing amount of interest over the life of a discounted bond.

D. Allocates bond interest expense using the current market rate for each interest period.

E. Is not allowed by the FASB.

104. A company issued 7%, 5-year bonds with a par value of $100,000. The market rate when the bonds were issued was 7.5%. The company received $97,947 cash for the bonds. Using the effective interest method, the amount of interest expense for the first semiannual interest period is: 

A. $3,500.00.

B. $3,673.01.

C. $3,705.30.

D. $7,000.00.

E. $7,346.03.

105. The market value of a bond is equal to: 

A. The present value of all future cash payments provided by a bond.

B. The present value of all future interest payments provided by a bond.

C. The present value of the principal for an interest-bearing bond.

D. The future value of all future cash payments provided by a bond.

E. The future value of all future interest payments provided by a bond.

106. The Premium on Bonds Payable account is a(n): 

A. Revenue account.

B. Adjunct or accretion liability account.

C. Contra revenue account.

D. Contra asset account.

E. Contra liability account.

107. Adidas issued 10-year, 8% bonds with a par value of $200,000. Interest is paid semiannually. The market rate on the issue date was 7.5%. Adidas received $206,948 in cash proceeds. Which of the following statements is True? 

A. Adidas must pay $200,000 at maturity and no interest payments.

B. Adidas must pay $206,948 at maturity and no interest payments.

C. Adidas must pay $200,000 at maturity plus 20 interest payments of $8,000 each.

D. Adidas must pay $206,948 at maturity plus 20 interest payments of $8,000 each.

E. Adidas must pay $200,000 at maturity plus 20 interest payments of $7,500 each.

108. A company received cash proceeds of $206,948 on a bond issue with a par value of $200,000. The difference between par value and issue price for this bond is recorded as a: 

A. Credit to Interest Income.

B. Credit to Premium on Bonds Payable.

C. Credit to Discount on Bonds Payable.

D. Debit to Premium on Bonds Payable.

E. Debit to Discount on Bonds Payable.

109. If an issuer sells bonds at a date other than an interest payment date: 

A. This means the bonds sell at a premium.

B. This means the bonds sell at a discount.

C. The issuing company will report a loss on the sale of the bonds.

D. The issuing company will report a gain on the sale of the bonds.

E. The buyers normally pay the issuer the purchase price plus any interest accrued since the prior interest payment date.

110. A company issues at par 9% bonds with a par value of $100,000 on April 1, which is 4 months after the most recent interest date. The cash received for accrued interest on April 1 by the bond issuer is: 

A. $750.

B. $5,250.

C. $1,500.

D. $3,000.

E. $6,000.

 

default image
July 1, 2023
    

 

101. On January 1, a company issued and sold a $400,000, 7%, 10-year bond payable, and received proceeds of $396,000. Interest is payable each June 30 and December 31. The company uses the straight-line method to amortize the discount. The journal entry to record the first interest payment is: 

A. Debit Bond Interest Expense $14,000; credit Cash $14,000.

B. Debit Bond Interest Expense $28,000; credit Cash $28,000.

C. Debit Bond Interest Expense $14,200; credit Cash $14,000; credit Discount on Bonds Payable $200.

D. Debit Bond Interest Expense $13,800; debit Discount on Bonds Payable $200; credit Cash $14,000.

E. Debit Bond Interest Expense $14,000; debit Discount on Bonds Payable $200; credit Cash $14,200.

102. A company issued 5-year, 7% bonds with a par value of $100,000. The company received $97,947 for the bonds. Using the straight-line method, the amount of interest expense for the first semiannual interest period is: 

A. $3,294.70.

B. $3,500.00.

C. $3,705.30.

D. $7,000.00.

E. $7,410.60.

103. The effective interest amortization method: 

A. Allocates bond interest expense over the bond's life using a changing interest rate.

B. Allocates bond interest expense over the bond's life using a constant interest rate.

C. Allocates a decreasing amount of interest over the life of a discounted bond.

D. Allocates bond interest expense using the current market rate for each interest period.

E. Is not allowed by the FASB.

104. A company issued 7%, 5-year bonds with a par value of $100,000. The market rate when the bonds were issued was 7.5%. The company received $97,947 cash for the bonds. Using the effective interest method, the amount of interest expense for the first semiannual interest period is: 

A. $3,500.00.

B. $3,673.01.

C. $3,705.30.

D. $7,000.00.

E. $7,346.03.

105. The market value of a bond is equal to: 

A. The present value of all future cash payments provided by a bond.

B. The present value of all future interest payments provided by a bond.

C. The present value of the principal for an interest-bearing bond.

D. The future value of all future cash payments provided by a bond.

E. The future value of all future interest payments provided by a bond.

106. The Premium on Bonds Payable account is a(n): 

A. Revenue account.

B. Adjunct or accretion liability account.

C. Contra revenue account.

D. Contra asset account.

E. Contra liability account.

107. Adidas issued 10-year, 8% bonds with a par value of $200,000. Interest is paid semiannually. The market rate on the issue date was 7.5%. Adidas received $206,948 in cash proceeds. Which of the following statements is True? 

A. Adidas must pay $200,000 at maturity and no interest payments.

B. Adidas must pay $206,948 at maturity and no interest payments.

C. Adidas must pay $200,000 at maturity plus 20 interest payments of $8,000 each.

D. Adidas must pay $206,948 at maturity plus 20 interest payments of $8,000 each.

E. Adidas must pay $200,000 at maturity plus 20 interest payments of $7,500 each.

108. A company received cash proceeds of $206,948 on a bond issue with a par value of $200,000. The difference between par value and issue price for this bond is recorded as a: 

A. Credit to Interest Income.

B. Credit to Premium on Bonds Payable.

C. Credit to Discount on Bonds Payable.

D. Debit to Premium on Bonds Payable.

E. Debit to Discount on Bonds Payable.

109. If an issuer sells bonds at a date other than an interest payment date: 

A. This means the bonds sell at a premium.

B. This means the bonds sell at a discount.

C. The issuing company will report a loss on the sale of the bonds.

D. The issuing company will report a gain on the sale of the bonds.

E. The buyers normally pay the issuer the purchase price plus any interest accrued since the prior interest payment date.

110. A company issues at par 9% bonds with a par value of $100,000 on April 1, which is 4 months after the most recent interest date. The cash received for accrued interest on April 1 by the bond issuer is: 

A. $750.

B. $5,250.

C. $1,500.

D. $3,000.

E. $6,000.

 

default image
July 1, 2023
    

 

101. On January 1, a company issued and sold a $400,000, 7%, 10-year bond payable, and received proceeds of $396,000. Interest is payable each June 30 and December 31. The company uses the straight-line method to amortize the discount. The journal entry to record the first interest payment is: 

A. Debit Bond Interest Expense $14,000; credit Cash $14,000.

B. Debit Bond Interest Expense $28,000; credit Cash $28,000.

C. Debit Bond Interest Expense $14,200; credit Cash $14,000; credit Discount on Bonds Payable $200.

D. Debit Bond Interest Expense $13,800; debit Discount on Bonds Payable $200; credit Cash $14,000.

E. Debit Bond Interest Expense $14,000; debit Discount on Bonds Payable $200; credit Cash $14,200.

102. A company issued 5-year, 7% bonds with a par value of $100,000. The company received $97,947 for the bonds. Using the straight-line method, the amount of interest expense for the first semiannual interest period is: 

A. $3,294.70.

B. $3,500.00.

C. $3,705.30.

D. $7,000.00.

E. $7,410.60.

103. The effective interest amortization method: 

A. Allocates bond interest expense over the bond's life using a changing interest rate.

B. Allocates bond interest expense over the bond's life using a constant interest rate.

C. Allocates a decreasing amount of interest over the life of a discounted bond.

D. Allocates bond interest expense using the current market rate for each interest period.

E. Is not allowed by the FASB.

104. A company issued 7%, 5-year bonds with a par value of $100,000. The market rate when the bonds were issued was 7.5%. The company received $97,947 cash for the bonds. Using the effective interest method, the amount of interest expense for the first semiannual interest period is: 

A. $3,500.00.

B. $3,673.01.

C. $3,705.30.

D. $7,000.00.

E. $7,346.03.

105. The market value of a bond is equal to: 

A. The present value of all future cash payments provided by a bond.

B. The present value of all future interest payments provided by a bond.

C. The present value of the principal for an interest-bearing bond.

D. The future value of all future cash payments provided by a bond.

E. The future value of all future interest payments provided by a bond.

106. The Premium on Bonds Payable account is a(n): 

A. Revenue account.

B. Adjunct or accretion liability account.

C. Contra revenue account.

D. Contra asset account.

E. Contra liability account.

107. Adidas issued 10-year, 8% bonds with a par value of $200,000. Interest is paid semiannually. The market rate on the issue date was 7.5%. Adidas received $206,948 in cash proceeds. Which of the following statements is True? 

A. Adidas must pay $200,000 at maturity and no interest payments.

B. Adidas must pay $206,948 at maturity and no interest payments.

C. Adidas must pay $200,000 at maturity plus 20 interest payments of $8,000 each.

D. Adidas must pay $206,948 at maturity plus 20 interest payments of $8,000 each.

E. Adidas must pay $200,000 at maturity plus 20 interest payments of $7,500 each.

108. A company received cash proceeds of $206,948 on a bond issue with a par value of $200,000. The difference between par value and issue price for this bond is recorded as a: 

A. Credit to Interest Income.

B. Credit to Premium on Bonds Payable.

C. Credit to Discount on Bonds Payable.

D. Debit to Premium on Bonds Payable.

E. Debit to Discount on Bonds Payable.

109. If an issuer sells bonds at a date other than an interest payment date: 

A. This means the bonds sell at a premium.

B. This means the bonds sell at a discount.

C. The issuing company will report a loss on the sale of the bonds.

D. The issuing company will report a gain on the sale of the bonds.

E. The buyers normally pay the issuer the purchase price plus any interest accrued since the prior interest payment date.

110. A company issues at par 9% bonds with a par value of $100,000 on April 1, which is 4 months after the most recent interest date. The cash received for accrued interest on April 1 by the bond issuer is: 

A. $750.

B. $5,250.

C. $1,500.

D. $3,000.

E. $6,000.

 

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Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

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Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

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Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

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Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

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Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

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