ADHD Flashcards

1
Q

Describe some causative factors associated with ADHD

A
  1. CNS Injury
  2. Genetics
  3. Environment
  4. Smoking, lead, low birth weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the characteristics of a child diagnosed with ADHD?

A

o Academic limitations
o Poor Peer Relationships
o Increased injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Identify symptoms of Inattention

A
  1. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
  2. Often has trouble holding attention on tasks or play activities.
  3. Often does not seem to listen when spoken to directly.
  4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
  5. Often has trouble organizing tasks and activities.
  6. Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
  7. Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
  8. Is often easily distracted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Identify symptoms of Hyperactivity and Impulsivity

A
  1. Often fidgets with or taps hands or feet, or squirms in seat.
  2. Often leaves seat in situations when remaining seated is expected.
  3. Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
  4. Often unable to play or take part in leisure activities quietly.
  5. Is often “on the go” acting as if “driven by a motor”.
  6. Often talks excessively.
  7. Often blurts out an answer before a question has been completed.
  8. Often has trouble waiting his/her turn.
  9. Often interrupts or intrudes on others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name and define the 3 presentations of ADHD

A
  1. Combined Type
  2. Predominantly Inattentive Type
  3. Predominately Hyperactive-Impulsive Type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the combined type of ADHD?

A

If enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the predominantly inattentive type like in ADHD?

A

If enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the predominately hyperactive-impulsive type like in ADHD?

A

If enough symptoms of hyperactivity-impulsivity but not inattention were present for the past six months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Identify factors that can help with evaluation of ADHD

A
  1. Family – parents (individually), siblings, extended family
  2. School
  3. Teachers
  4. Report Cards
  5. Past Medical Records
  6. Rating Scales – Vanderbilt, BASC
  7. Psychological Evaluations
  8. Family History
  9. Home Environment
  10. Social Events
  11. Babysitters
  12. School Functioning
  13. Peer Relationships
  14. Police Records, problems with authority
  15. Associated Complaints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe treatment goals for ADHD?

A

o Improved Cognition
o Decreased motor activity
o Improved social skills
o Improved efficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe all treatments for ADHD

A
1. Behavioral Counseling
A. CONSISTENCY
B. Positive Reinforcement
C. Time Management
D. Parents / Child / School
2. Parenting Classes
3. Medication
4. School Involvement
5. Activities
6. Other Problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

DSM V Diagnosis guidelines

A

Inattention
Hyperactivity – impulsivity
Duration at least 6 months
Onset before age 12 (was 7)
Impairment in 2 or more settings (home, work, school, social situations)
Clinically significant impairment must be evident in social, academic, or occupational functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Symptoms of inattention: How many do children up to 16 need for a diagnosis?

A

6 or more!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms of inattention: How many do adolescents 17 and older need for a diagnosis?

A

5 or more!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Symptoms of hyperactivity & Impulsivity: How many do children up to 16 need?

A

6 or more!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of hyperactivity & Impulsivity: How many do adolescents 17 and older need?

A

5 or more!

17
Q

Which 2 neurotransmitters are out of balance in ADHD?

A
  1. Dopamine

2. Serotonin

18
Q

Differential Diagnoses for ADHD

A
Mood Disorders
Anxiety Disorders
Psychosis
Pervasive Developmental Disorder
Learning Disabilities
Poor environmental controls
Family Dysfunction
PTSD
Oppositional Defiant Disorder
Conduct Disorder
Tourette’s Syndrome
Age – appropriate over-activity
19
Q

Factors that will delay a diagnosis of ADHD?

A
Primary Inattentive Subtype
Female Sex
Highly Supportive Family
High IQ
Well Developed Social Skills
20
Q

Name some neurodevelopment disorders associated with ADHD?

A
Fetal alcohol syndrome 
Alcohol related neurodevelopment disorder
Down syndrome
Prader-Willi syndrome
Williams syndrome   
Tourette syndrome
Turner syndrome
21
Q

FDA approved Medications for ADHD?

A
  1. Stimulants
    A. Methylphenidate (eg: Ritalin, Concerta, Focalin)
    B. Amphetamine (eg: Dexedrine, Adderall, Vyvanse)
  2. Non-stimulants
    A. Atomoxetine (Strattera)
    B. Guanfacine XR (Intuniv)
    Clonidine XR (Kapvay)
22
Q

MOA: Stimulant (Methylphenidate)

A

Blocks dopamine uptake by inhibition of dopamine transporter (DAT) of central adrenergic neurons

23
Q

MOA: Stimulant (Amphetamines)

A

Not only block Dopamine Transporter (DAT) but also increase catecholamine release as a primary mechanism

24
Q

Which non-stimulant medication is approved for the treatment of children, adolescents, & adults with ADHD?

A

Atomoxetine (Strattera)

25
Q

Which non-stimulants are approved for treatment of solely children & adolescents 6-17? No adults

A
  1. Guanfacine XR (Intuniv)

2. Clonidine XR (Kapvay)

26
Q

What is the MOA for non-stimulant Atomoxetine (Strattera)?

A

Blocks reuptake at the noradrenergic neurons

27
Q

MOA for non-stimulants: Guanfacine XR (Intuniv) & Clonidine XR (Kapvay)?

A

An alpha-2A adrenergic receptor agonist

28
Q

What is the initial medical work up for stimulants?

A
  1. Physical Exam
  2. Height and Weight
  3. Blood Pressure and Pulse
  4. Lab tests as baseline data (cbc and dif, LFT) Screening for tics, involuntary movements
  5. Pregnancy Tests
29
Q

Most Common (less severe) SE of Stimulants

A
Decreased appetite
Insomnia
Gastrointestinal pain
Rebound phenomena
Mood swings and irritability
Increased heart rate (clinically insignificant)
30
Q

Less common (more severe) SE of Stimulants

A
Growth retardation
Tic disorders
Psychosis
Mood swings / depression
Increased heart rate and BP (significant)
31
Q

Children < 5 yrs should not be given what as a treatment of first choice?

A

Stimulants

A. Higher incidence of SE

32
Q

What drug is not approved for children <6 years old?

A

Methylphenidate

33
Q

Short acting and long acting Methylphenidate’s include?

A
1. Short Acting
A. Ritalin
B. Focalin
2. Long Acting
A. Ritalin SR
B. Metadate CD
C. Concerta
D. Ritalin LA
E. Patches
F. Quillivant Elixir
34
Q

Short and long acting Amphetamine’s?

A
1. Short Acting
A. Dexedrine
B. Adderall
2. Long Acting
A. Dexedrine Spansule
B. Adderall XR
C. Vyvanse
35
Q

With ADHD there is increased risk for what?

A
  1. Conduct Disorder
  2. Antisocial Personality Disorder
  3. Psychiatric problems