Chapter 65: ADHD Flashcards
(57 cards)
What do stimulant medications raise in the treatment of ADHD?
Dopamine and NE
What is the first-line treatment for pre-school aged children (age 4-5 years)?
Parent training in behavior management and/or behavioral classroom intervention
ADHD medications are considered first-line in patients older than how many years?
6
What are the DSM-5 diagnostic criteria for inattention?
6+ symptoms of inattention for children up to age 16, OR 5+ symptoms for ages 17 and older. Symptoms must have been present for at least 6 months.
Fails to pay attention, trouble holding attention, does not pay attention when someone is talking, does not follow through on instructions, fails to finish schoolwork, has difficulty organizing tasks, avoids or dislikes tasks which require mental effort, loses things, is easily distracted and is forgetful.
What are the DSM-5 diagnostic criteria for hyperactivity and impulsivity?
6+ symptoms of hyperactivity-impulsivity for children up to age 16, OR 5+ symptoms for ages 17 and older. Symptoms must have been present for at least 6 months.
Often fidgets or squirms, leaves seat unexpectedly, runs about when not appropriate, unable to play quietly, is “on the go” as if “driven by a motor,” talks excessively, blurts out answers, has trouble waiting his/her turn and interrupts or intrudes on others.
Which conditions must be met in order to be diagnosed with ADHD?
Several inattentive or hyperactive-impulsive symptoms were present before the age of 12, symptoms must have been present in 2 or more settings (e.g., at home, school, work, with friends or relatives, babysitters), symptoms interfere with functioning, and are not caused by another disorder.
Which natural product is used for a variety of psych conditions and has shown to modestly improve cognitive function and behavior in children with ADHD?
Fish oils
What natural product can be taken to help with sleep onset in individuals taking stimulants?
Melatonin
What formulation of stimulants are preferred for children who would otherwise need a dose during the day at school?
Long-acting
A child or person who cannot swallow capsules or tablets can use these long-acting stimulant formulations:
Capsule, Chewable tablet, ODT, Patch, Suspension
Which stimulant capsules can be opened and sprinkled on a small amount of applesauce?
Adderall XR, Ritalin LA
Which stimulant medication can be opened and mixed in water, orange juice, or yogurt?
Vyvanse capsule
True or False: You can warm the food when sprinkling capsule contents, but you must take it right away.
False - do NOT warm the food
Which medication can be used first line when prescribers are concerned about the possibility of abuse by the patient or family?
Atomoxetine (Strattera)
Which non-stimulant medication can be tried when stimulants do not work well enough after a trial of 2-3 medications?
Atomoxetine (Strattera)
Which medications can be taken to help sleep while taking stimulants?
Clonidine IR (Catapres), diphenhydramine (OTC, 25-50 mg), melatonin (OTC, 2-5 mg)
Do not use stimulants within ___ days of ____
14 days of MAOi
What causes the increased HR and BP in patients taking stimulants?
Increased levels of DA and NE. Assess for cardiac disease at baseline
What other vascular problems can occur when taking stimulants?
Priapism and Raynaud’s disease
What can stimulants cause when used with other serotonergic drugs?
Serotonin syndrome
What is a common side effect of stimulants related to appetite?
Loss of appetite
How can loss of appetite from stimulants affect children?
It can contribute to a decrease in growth trajectory
What is the mechanism of action (MOA) of stimulants?
Block the reuptake of NE and DA
How often can stimulant doses be titrated up to reduce adverse events?
Every 7 days
