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PHRM 845 Therapeutics > Exam 4 - Lec 64 ADHD Ott > Flashcards

Exam 4 - Lec 64 ADHD Ott Flashcards

1
Q

____ of children with ADHD will have the diagnosis in adulthood

a. 1/4
b. 1/3
c. 1/2

A

b. 1/3

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2
Q

which of the following is FALSE about ADHD?

a. higher rate if diagnosed in a first degree relative
b. etiology is multifactorial (environmental, genetics, physiological)
c. dec risk of substance use and antisocial personality disorder if ADHD left untreated

A

c. dec risk of substance use and antisocial personality disorder if ADHD left untreated

(it would be increased)

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3
Q

which of the following is FALSE about ADHD diagnostic criteria?

a. for each sx domain, must have at least 6 sx present
b. for ages 17 and up, at least 5 sx are required for either of the two specifiers
c. several inattentive or hyperactive sx must be present prior to age 10
d. sx are present in 2 or more settings

A

c. several inattentive or hyperactive sx must be present prior to age 10

(prior to age 12)

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4
Q

look at slide 8 and 9 for sx of inattention and hyperactivity

A

ok

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5
Q

T or F: for stimulant dosing, we calculate pediatric pts based on mg/kg

A

F (variations in dosing not found to be due to height or weight)

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6
Q

IR stimulants are preferred for pts weighing < ___ kg due to limited low-dose availability of LA stimulants

A

< 16 kg

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7
Q

T or F: for stimulant dosing, late afternoon sx may require longer-acting formulation

A

T

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8
Q

T or F: pts can take an amphetamine-based and methylphenidate-based stimulant at the same time

A

F

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9
Q

Mydayis is indicated for pts age ___ and up

A

13

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10
Q

Mydayis dose for ages 13-17

a. 25 mg/day
b. 12.5 mg/day

A

b. 12.5 mg/day

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11
Q

what is the formulation for Daytrana?

A

patch

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12
Q

what medication is a prodrug that is converted to dextroamphetamine?

a. Mydayis
b. Daytrana
c. Vyvanse
d. Jornay PM

A

c. Vyvanse

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13
Q

when should a Jornay PM dose be taken?

A

in the evening between 6:30-9:30 pm (helps with morning problems)

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14
Q

which of the following are NOT considered common AE’s of stimulants?

a. stomach ache
b. insomnia
c. hallucinations
d. reduced appetite
e. risk for sudden cardiac death
f. jitteriness

A

c, e (these ones are uncommon)

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15
Q

if a pt experiences hallucinations from a stimulant, how should we manage it?

a. reduce dose
b. d/c stimulant and reassess diagnosis
c. divide dose, give with food
d. switch formulation

A

b. d/c stimulant and reassess diagnosis

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16
Q

two alpha 2 agonists for ADHD

A

guanfacine ER
clonidine ER

17
Q

guanfacine ER is a substrate of which CYP?

a. 1A2
b. 2D6
c. 3A4

A

c. 3A4

18
Q

alpha 2 agonists must be tapered if d/c to avoid _____ _____

A

rebound hypertension

19
Q

two NE reuptake inhibitor drugs

A

atomoxetine
viloxazine

20
Q

which of the following is FALSE about atomoxetine?

a. it is an NE reuptake inhibitor
b. 2D6 substrate
c. weight-based dosing
d. none of the above

A

d. none of the above

21
Q

which of the following is FALSE about viloxazine?

a. 2D6/UGT substrate
b. strong 1A2 inhibitor
c. weight-based dosing
d. capsules can be swallowed whole or put in applesauce

A

c. weight-based dosing

22
Q

which drug class causes inc HR and BP, and has a boxed warning for increase in suicidal thinking?

a. NE reuptake inhibitor
b. alpha 2 agonists

A

a. NE reuptake inhibitor

23
Q

which drug class has the following AE?

-dec HR and BP, orthostasis
-somnolence
-dizziness
-rebound HTN if abrupt d/c

a. NE reuptake inhibitor
b. alpha 2 agonists

A

b. alpha 2 agonists

24
Q

LFTs and growth rate should be monitored for which non-stim medication?

a. clonidine
b. guanfacine
c. atomoxetine
d. viloxazine

A

c. atomoxetine

25
Q

T or F: bupropion is FDA-approved for ADHD

A

F

26
Q

bupropion CI (2 of them)

A

seizure disorders and eating disorders

27
Q

bupropion is a ____ inhibitor

a. 1A2
b. 2D6
c. 3A4

A

b. 2D6

28
Q

T or F: TCAs are more effective than methylphenidate

A

F

29
Q

TCAs have ______ concerns - sudden ______ death in children, lethal in overdose (same word in each blank)

A

cardiac

30
Q

mood stabilizers and atypical antipsychotics may be useful if a pt with ADHD also has one of what 3 conditions?

A

bipolar disorder
conduct disorder
intermittent explosive disorder

31
Q

T or F: atypical antipsychotics can be used as monotherapy for ADHD

A

F

32
Q

AAP first line medication recommendation for preschool age pts

A

methylphenidate

33
Q

AAP first and second line tx for elementary/middle school/adolescents pts

A

first line: stimulants
second line: atomoxetine, guanfacine or clonidine ER

34
Q

according to AAP, what two drugs can be used as adjuncts to stimulants?

A

clonidine ER and guanfacine ER

35
Q

look at the NICE: ADHD Guidelines 2018 for adults (slide 31)

A

fo sho

PHRM 845 Therapeutics (34 decks)

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