ADHD (lec 1) Flashcards Preview

Q4 Psych > ADHD (lec 1) > Flashcards

Flashcards in ADHD (lec 1) Deck (22):
1

ADHD definition?

more severe or frequent persistent pattern of inattention and/or hyperactivity-impulsivity than typical

sxs affect cognitive, academic, behavioral, emotional, social fxning

2

Pathophys of ADHD?

(P) ↓ dopamine/norepi in brain
(P) environmental

3

Inattention presents as?

careless mistakes
doesn't listen
doesn't follow thru
can't organize
loses things
forgetful

4

Hyperactivity-Impulsivity presents as?

runs/climbs inappropriately
excessive talking
fidgeting
can't wait turn
interrupts/intrudes

5

Types of ADHD?

1) Combined (inattentive AND hyper-impulsive)
2) Predominantly Inattentive
3) Predominantly Hyper-Impluse

6

DMS Dx Criteria for ADHD?

≥ 6 inattent or hyper sxs lasting ≥ 6 mo and inconsistent w/ developmental level

sxs before age 7

sxs of impairment in ≥ 2 settings

clinically significant impairment in social, academic, occupational fxn

sxs not accounted for w/ other mental disorder

7

ADHD eval includes? (4)

1) Comprehensive developmental, educational, psych/soc
2) Review medical, social, family hxs
3) Interview patient/parents
4) Info from caregivers/teachers

8

Purpose of ADHD eval? (4)

1) confirm sxs
2) find fxnl complications
3) exclude other causes of sxs
4) identify comorb psych conditions

9

Questions for parents?

1) Doing in school?
2) Learning problems?
3) Happy in school?
4) Behavior problems school/home/play?
5) Problems completing things?

10

Questions for teachers?

1) Behavior?
2) Interventions required?
3) Learning patterns?
4) Fxnl impairment?
5) Child's schoolwork?
6) Grades?

11

Rating scales completed by whom?

Parents and teachers

12

Rating scales done when?

diagnosis
med titration
regular med f/u

13

Behavior modifications include? (9)

1) daily schedule
2) minimize distractions
3) specific/logical places to keep work/toys/clothes
4) small, reachable goals
5) positive rewards
6) charts/checklists to help staying on task
7) limit choices
8) activities child can do
9) calm discipline

14

Educational interventions? (9)

1) tutoring
2) individualized programs
3) write assignments on board
4) smaller class sizes
5) sit by teacher
6) frequent breaks
7) extra time for tasks
8) signal for teacher when off task
9) daily reports to parents

15

Criteria for meds? (8)

1) complete/confirmed diagnosis of ADHD
2) ≥ 6 yo
3) parents agree meds are part of overall mgt
4) school will cooperate
5) healthy HR/BO w/o seizures, tourettes
6) w/o developmental delay
7) w/o significant anxiety
8) no risk of substance abuse in household

16

Stimulants for ADHD?

1st line tx

methylphenidate (Ritalin)
dextroamphetamine (Dexedrine)
mixed amphetamine salts (Adderall)

17

Stimulants dosing: Short-acting?

Long-acting?

BID-TID

QD

18

Stimulants physio?

release catecholamines ->
dopamine/norepi ↑ attention span/concentration

19

Stimulant S/Es?

Anorexia/weight loss
Sleep disturbance
↑ HR/BP
HA
Social w/drawal
Nervousness
Irritability
Tics
Stomach pain
Sudden cardiac death

20

Atomoxetine (Strattera) mechanism?

Benefits?

Cons?

selective norepi reuptake inhibitor

NOT controlled substance
Less abuse potential

Expensive

21

Atomoxetine (Strattera) S/Es?

Same as stims
N/V
Severe liver injury
↑ suicidal thoughts

22

Other meds for ADHD?

Antidepressants:
TCA, dopamine reuptake inhib

α2-agonists:
clonidine, guanfacine