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Pharmacotherapy of Pediatrics Flashcards

(59 cards)

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1
Q

T or F: Kids have less risk for significant adverse effects from medications than adults

A

F (higher risk)

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2
Q

T or F: Tics are constant and present for more than 1 year.

A

F (tics may wax and wane in frequency)

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3
Q

Tourette’s disorder onset

A

before the age of 18

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4
Q

What percent of people with Tics have ADHD
a. 25%
b. 50%
c. 75%
d. 85%

A

C. 75%

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5
Q

What percent of people with Tics have OCD
a. 25%
b. 50%
c. 75%
d. 85%

A

B. 50%

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6
Q

What is the Rule of thirds

A

1/3 resolve, 1/3 improve,1/3 stay the same- 10% have persistent symptoms as adults

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7
Q

What is the First line treatment of Tics
A. Alpha 2 agonists
B.Atypical antipsychotics
C. Typical antipsychotics

A

A. Alpha 2 agonists

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8
Q

What are alpha 2 agonists?

A

Clonidine, Guanfacine and Er Guanfacine

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9
Q

What is the Second line treatment of Tics
A. Alpha 2 agonists
B.Atypical antipsychotics
C. Typical antipsychotics

A

B. Atypical antipsychotics (aripiprazole and risperidone)

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10
Q

What is the third line treatment of Tics
A. Alpha 2 agonists
B.Atypical antipsychotics
C. Typical antipsychotics

A

C. Typical antipsychotics (haloperidol)

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11
Q

What age is Aripiprazole approved for?

A

6-17 years old

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12
Q

T or F: must treat both ADHD and Tourette’s

A

T

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13
Q

T or F: When treating ADHD and Tourettes you have to continue amphetamine-based stimulants and give a trial of atomoxetine or a tricyclic antidepressant

A

False ( can discontinue amphetamines, but able to resume if ADHD symptoms are not well-controlled and adjust antipsychotic dose to control tourettes)

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14
Q

What is childhood onset?

A

<10 years old

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15
Q

what is adolescent-onset type?

A

> 10 years (no symptoms under 10 years old)

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16
Q

what is unspecified onset?

A

unclear information to determine age at onset

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17
Q

T or F: When treating OCD we should treat underlying condition (ADHD, depression/anxiety, mania) – ADHD common

A

True

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17
Q

T or F: Stimulants and clonidine/guanfacine are considered drugs of first choice before using atypical antipsychotics

A

T

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18
Q

T or F: Atypical antipsychotics should not be used to treat severe persistent aggression, serious oppositional behaviors, defiance

A

False they may be used

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19
Q

When should pharmacotherapy be considered

A

baseline symptoms/behaviors have been determined, other interventions have failed and/or aggression has escalated to dangerous levels. pharmacotherapy is considered adjunctive, pallative, and non-curative

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20
Q

What is the first line treatment for mild anxiety?
A. pharmacotherapy
B. psychotherapy
C. combo therapy

A

B. psychotherapy

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21
Q

what is the first line treatment for moderate to severe anxiety?
A. pharmacotherapy
B. psychotherapy
c. Combo therapy

A

C. Combination therapy

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22
Q

What is the first line drug therapy for separation anxiety

A

SSRI

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23
Q

What is important when treating separation anxiety?

Study These Flashcards
A

treat co-morbidities like depression ADHD and screen for bipolar disorder

24
DSM-5 Autism spectrum disorder criteria
Persistent deficits in social communication and social interaction across multiple context Restricted, repetitive patterns of behavior, interests, activities
25
What are the signs and symptoms of ASD
Associated behavioral symptoms: aggression, hyperactivity, inattention, irritability, mood instability, poor frustration tolerance, self-harm, severe temper tantrum, sleep disturbances, OCD symptoms, hypersensitivity of senses
26
T or F: No medications have shown efficacy in treating the core ASD symptoms
True
27
What are associated medical problems of ASD
seizure disorder (up to 30% have at least on seizure by age 20) and GI disorders
28
what is the first line tx for disruptive behaviors in ASD
Behavioral interventions are first-line treatment (Applied Behavioral Analysis)
28
What first line agents are approved for the management of irritability/aggression and may have efficacy for sterotypy and hyperactivity
Atypical antipsychotics: aripiprazole (6 – 17 years old) and risperidone (5 – 16 years old)
29
which drugs have no significant effect on irritability A. Lamotrigine B. Aripiprazole C. Risperidone D. Levitiracetam
A and D
30
What medications can be used for repetitive behaviors select all that apply A. methylphenidate B. haloperidol C. clonidine D.Guanfacine E. Risperdone F. Aripiprazole
B, E,F
31
What medications can be used for ADHD A. haloperidol B. methylphenidate C. Clonidine D. melatonin E. guanfacine
B, C, E Clonidine and guanfacine have a modest effect on irritability and explosive behavior
32
What medications can be used for sleep A. haloperidol B. methylphenidate C. Clonidine D. melatonin E. guanfacine
D. melatonin reduces sleep latency and increased time asleep give 1-6mg nightly
33
What is Disruptive Mood Dysregulation Disorder (DMDD)
Severe recurrent temper outbursts manifested verbally that are out of proportion with the intensity/duration of the situation Present in at least two of three settings (home, school, with peers) and are severe in at least one of these
34
T or F: Diagnosis of DMDD should be made before the age of 6 or after the age of 18
False they should not be made before the age of 6 or after 18
35
What is first line treatment for DMDD
SSRIs and stimulants DMDD has more similarity to depression ADHD or anxiety than BPD (make sure pt doesn't have BPD)
36
Pediatric depression in children
physical complaints, irritability, conduct problems, can have suicidal ideation
37
Pediatric depression in Adolescents
express feelings of depression and suicidal behaviors than more than younger children
38
T or F: Pediatric depression is more chronic than episodic, instability in mood common; may be marker for bipolar disorder
true
39
CBT has a remission rate of A. 20% B. 50% C. 60% D.70%
D
40
What is the first line for depression tx
Nonpharmacologic treatment is first-line, need motivation of family/caregivers for success
41
What is the Black box warning for Antidepressants
warning for suicidality, Highest risk in 1st 3 months of treatment, Med guide with each prescription, Antidepressants may lower completed suicide rate Paroxetine is first antidepressant with this warning avoid in kids
42
Which antidepressant is FDA approved to treat kids down to 8 years old A. Paroxetine B. sertraline C. Fluoxetine D. fluvoxamine
C
43
What ages are escitlopram approved in A. <8 B. 10-18 C. 12-17 D.18>
C
44
What is first line treatment for Pediatric PTSD
Trauma-focused psychotherapy
45
What is a medication used In BPD
lithium
46
What is the first line drug treatment for PTSD
SSRIs
47
What diagnostic criteria is used for childhood onset Schizophrenia
adult diagnostic criteria
48
Childhood onset schizophrenia signs
hallucinations not explained by substance use or PDD/autism more visual hallucinations than what is seen in adults onset before age of 13 rare in children adolescent prevalence reaches adult prevalence of 0.5-1.0%
49
Aripiprazole (albilify) indications and ages
Bipolar Disorder 10 – 17 years irritability with Autism 6 – 17 years Schizophrenia 13 – 17 years Tourette’s Disorder 6 – 17 years
50
Asenapine (Saphris) indications and ages
Bipolar Disorder:10 – 17 years
51
Brexpiprazole (Rexulti ) indications and ages
Schizophrenia : 13 – 17 years
52
Lurasidone (Latuda) indications and ages
Schizophrenia 13 – 17 years Bipolar Depression 10-17 years
53
Olanzapine (Zyprexa) indications and ages
Bipolar Disorder and Schizophrenia 13-17
54
Olanzapine/Fluoxetine (Symbyax) indications and ages
Bipolar I Depression 10 – 17 years
55
Paliperidone (Invega) indications and ages
Schizophrenia 12-17 years
56
Quetiapine (seroquel) indication and ages
Bipolar Disorder 10-17 Schizophrenia 13-17
57
Risperidone (risperdal) indication and ages
Bipolar Disorder 10-17 years Irritability with Autism 5-17 years Schizophrenia 13-17 years

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