Off-Label Drug Use in Pediatrics

 

Watch media in the link below to write the paper:
http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_02/index.html

To Prepare
• Review the interactive media piece above 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 2-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.

 

Sample Solution

Off-Label Drug Use in Pediatrics

The Food and Drug Administration (FDA) approved the use of the antidepressant Prozac (fluoxetine) as a treatment for children and adolescents 7 to 17 years of age with depression (major depressive disorder) or obsessive-compulsive disorder (OCD) in 2003. But just because a medicine is not FDA approved does not mean that it is not safe. Many drugs are not FDA-approved for use in kids but are still used “off-label,” meaning that they are used in children younger than the approved age or for other conditions that they are not approved for yet. The use of albuterol to treat children with asthma is a good example of the safe `off-label` use of a drug. These medications are used because there are no other medications to use and these medicines have been used so much, they are thought to be safe and studies have shown that they work.

An arguably more evident issue surrounding the creation of choice is that of equity and the ability to exercise choice (Ball, 2008; Burgess, Greaves, Vignoles and Wilson, 2015). Though some commentators have noted that parents are likely to be willing to pay more for a better quality of education (Bridges and McLaughlin, 1994), in some instances this lacks the inseparable discussion that not all parents can afford to pay for education, or to travel further than their local school, inevitably constricting choice (Alderman, Orazem and Paterno, 2001; Burgess et al., 2015; Hastings and Weinstein, 2008). Derived from this discussion is the consideration of ‘active’, ‘passive’ and ‘none choosers’ (Goldring and Phillips, 2008). Active choosers are typically middle-class, well-educated parents who can understand the published data and make their choice accordingly (Edwards and Tomlinson, 2002). None choosers, in contrast, are typically those from poorer socioeconomic backgrounds that are confined to their local school, regardless of its suitability. Whilst the perspective of conflict theory may consider levels of choosing power as an engineered form of social segregation (Collins, 1971), it appears more credible that this is reflective of the cultural capital discussed by Bourdieu (1986), with active choosers benefitting from a more extensive network to inform their choice (Brighouse, 2002). Therefore, whilst it cannot be ignored that the children of active choosers are more likely to succeed in education and benefit from neoliberal principals, a more holistic evaluation concludes that the neoliberal ideology is not adequately suited to markets where consumers do not have an equal opportunity to purchase the product, such as education.

Acknowledgement of issues around equity has been present in government policy for a number of years with potential solutions proposed including voucher systems such as that used in Chile, the covering of transport costs for those that are disadvantaged, the availability of choice advisors to demystify the published data around schools (Stiell, Shipton, Coldron and Coldwell, 2008), all flourished by a rhetoric of “advantage based on merit not privilege” (May, 2016, para 19). Despite these measures, the most recent annual report by Ofsted (2018) identified 490 schools that have been stuck in a cycle of poor performance since 2005 and it is this that is arguably the most alarming outcome of choice mechanisms in education. Such a cycle is underpinned by the notion that parents of educationally successful children choose those institutions perceived as desirable, with parents of more challenging children forced to choose thei

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