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Flashcards in 81B ADHD Deck (17):
1

ADHD diagnostic criteria

1) 6 or more symptoms of (adults need 5)
A) inattention
and/or
B) hyperactivity-impulsivitity
2) >= 6 months; present before age 7
3) symptoms inconsistent with developmental level
4) impairment in 2 or more settings (?)
5) clinical significant impairment in at least one domain of functioning
A) social
B) academic
C) occupational

2

ADHD Inattention symptoms

careless mistakes
difficulty paying attention
doesn't follow through
not organized
loses shit
forgetful

3

ADHD hyperactice symptoms

Fidgety
doesn't stay seated
runs/climbs at odd time
noisy
talks too much

4

ADHD Impulsive symptoms

Blurts out answers
difficulty awaiting turn
interrupts

5

Core features of ADHD

-poor self-regulation and impulsive
-seeks immediate reinforcement with no tolerance of delay
-poor motivation when bored

6

Who gets ADHD

Boys, mostly inattentive type

7

brain structure/function in ADHD

smaller executive functioning areas and dopaminergic underactivity, but imagining not diagnostic

8

ADHD Course

-majority have symptoms into adolescence and half into adulthood; poor school performance, self esteem, etc.
-W/ Oppositional defiant disorder/Conduct disorder --> hoodlum

9

ADHD Assessment

Parent/spouse interview
Patient interview
School assessments
Teacher
physical w/in year + medical hx and ROS

10

Additional ADHD testing

**Only if indicated
Thyroid, lead, EEG (seizures), vision, hearing, sleep
IQ if grades suck
Speech/language if delayed

11

ADHD Treatment - NIMH MTA study results

systematic medication with or without behavioral treat is best for...
1) core ADHD symptoms
2) aggression
3) oppositional-defiant behaviors
4) social functioning
use behavioral therapy/skills remediation for other specific areas

12

ADHD stimulant treatment evidence

safe and efficient
96% of kids improve
non-responders to one improve on the other

13

ADHD stimulant types

Methylphenidate (dl- and d-)
Amphetamine
1) dextroamphetamine
2) mixed amphetamine salts
3) lisdexamfetamine

14

ADHD stimulant action

stimulate under active parts of brain
increase focus, motivation, productivity
increase dopamine and NE in prefrontal cortex
decrease motor activity, less disruption

15

ADHD stimulant side effects

Irritability
Headaches
Abdominal pain
reduced appetite

16

ADHD stimulant abuse

only at high doses via snorting/injection
no tolerance

17

Nonstimulants for ADHD

Atomoxetine - 2nd line; increases dopamine and NE in prefrontal cortex
A-adreneric agonists - 2nd line
1) guanfacine
2) clonidine