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Question
Amir is a 7-year-old boy who is referred to your care by the Department of Youth and Family Services. He is currently working with a therapist and has been in and out of various pediatric mental health facilities for the last 2 years. He had a traumatic early childhood, was separated from his mother at birth because she was deemed unfit, but has since been returned to her care for the last few years. He has been on a variety of medications for various medical diagnoses over the last couple of years and his mother says nothing helps. He has a 5-year-old sister and has gotten angry with her and broken her nose. He still wears pull-ups because he refuses to use the bathroom appropriately. He goes to school but is repeatedly in trouble with his teacher. He has threatened to shoot his teacher, and the mom says she is afraid to leave him with her other children.
1. Propose your pharmacologic regimen for Amir and explain your choice.
2. Are there any risks inherent to this plan of care? If so, what is your risk reduction strategy?
3. Describe any ethical concerns and how you will address them.
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