ADHD Flashcards
(6 cards)
1
Q
Definition of ADHD
A
ADHD is characterised by a persistent pattern if inattention and/or hyperactive-impulsivity, with onset during the developmental period, typically early to mid-childhood
2
Q
Neurobiology and basis for treatment
A
- both dopamine and noradrenaline are involved in the treament response
- other neurotransmitters include glutamate and serotonin
- DA modulates reward in the ventral striatum - ADHD patients need higher rewards
- DA modulates working memory and inhibitory functions in fronto-straited circuits - ADHD patients have impaired prefrontal cognitive functions and show hypoactivation in prefrontal circuits
- two firing modes: tonic (background) and phasic (intermitted pulses) - ADHD patients have a reduced tonic pool of DA - they compensate with increased phasic release
3
Q
What are the ADHD treatment targets?
A
- Educate about disorder and its managment
- support the individual
- improve core symptoms
- address the associated impairments
- treat the psychiatric co-morbidity
- monitor physical health
4
Q
What are the pre-medication checks? for ADHD?
A
- confirm the diagnosis
- review of mental health comorbidities
- risk assessment for substance misuse and drug diversion
- review physical health:
- medical history, current
medication and
contraindications
- height and weight, pulse and
BP
- a cardiovascular assessment
5
Q
How to monitor physical health for patient?
A
- BP and pulse
- recorded at baseline and
before and after dose change
- recorded routinely every 6
months - weight
- recorded at baseline then
every 6 month
Annual review:
- at least once a year
- consider trial periods of
stopping medication or reduce
dose
6
Q
What are the medications to treat ADHD?
A
- 1st line: Lisdexamfetamine or
methylhenidate - Switch those who have not
derived enough benefit (from
first trial) to lisdex.. or methyl..
following a 6-week trial at an
adequate dose - consider atomoxetine if poor
response or tolerance to
stimulants
