Question

"A 7-year-old boy has just been diagnosed with ADHD, combined type, and his care provider feels that the best therapeutic choice is a stimulant. Family history is significant for depression and diabetes. The child's medical history is significant for asthma. According to current recommendations, what should be the care provider's next step?

a) Prescribe a stimulant, as no additional tests are indicated for this child
b) Obtain an electrocardiogram (ECG), as this child's family and physical exam warrant it.
c) Obtain an electrocardiogram (ECG), as this is mandatory prior to prescribing a stimulant to any child
d) Prescribe a non-stimulant, as a stimulant would not be appropriate for this child"

Answer 1

The care provider should prescribe a stimulant as no additional tests, such as an ECG, are indicated for this child before initiating treatment for ADHD. The child's family history of depression and diabetes, and their asthma, do not mandate an ECG.

Step-by-step explanation:

When a 7-year-old boy has been diagnosed with ADHD, combined type, and a stimulant medication is considered as the therapeutic choice, family history and medical conditions must be taken into account before prescribing medication. In this scenario, the fact that the child has a family history of depression and diabetes, along with a personal medical history of asthma, does not mandate an electrocardiogram (ECG) before proceeding with stimulant medication. However, it is good practice for the care provider to consider any potential cardiac risk factors before initiating treatment with stimulants and to follow standard treatment guidelines, which include a regular follow-up and monitoring of symptoms and side effects.

Therefore, the correct answer for the care provider's next step would be: a) Prescribe a stimulant, as no additional tests are indicated for this child. Stimulant drugs, such as amphetamines, can paradoxically have a calming effect and are a common therapeutic choice for treating ADHD, as they increase neurotransmitter activity within certain brain areas including the prefrontal cortex and basal ganglia, which are associated with impulse control.