64 - ADHD Flashcards
- higher rate if diagnosed on a ___ degree relative
- etiology is ___ (environment, genetics, physiological)
- first
- multifactorial
- ___ of children with ADHD will have the diagnosis in adulthood
- increased risk of ___ use and anti-social personality disorder is ADHD is left untreated
- 1/3
- substance
diagnostic criteria
for each symptom domain, must have at least __ symptoms present
- >17 yo at least 5 symptoms for with of 2 specifiers
- several inattentive or hyperactive symptoms must be present prior to age ___ years
- several inattentive or hyperactive impulsive symptoms are present in ___ or more settings
6
12
2
Inattentention
__ or more of the following symptoms persistening for at least __ months
6
6
hyperactivity and impulsivity
__ or more of the following symptoms persistening for at least __ months
6
6
stimulants (2) based
amphetamines
methylphenidate
non-stimulants
MOA ADHD Treatment options
stimulants
- inhibition of ___ and ___ , inhibition of ___
- increased amount of DA and NE in synapse
- inhiibition of ___ oxidase (amphetamines are more potent)
- amphetamines - ability to enter the presynaptic terminal and cause ___ of neurotransmitters
- DAT, NET, reuptake
- monoamine
- release
v
guanfacine and clonidine
- selective ___ agonist
- theorized that use in ADHD is related to binding of receptors in the ___ cortex
- a2A
- pre-frontal
MOA ADHD Treatment options
atomoxetine and viloxazine
- ___ inhibition ___ reuptake
selective, NE
stimulant dosing
- dose response effects seen in a short period of time
- calculating a dose in pediatric patients based on mg/kg not found to be helpful, not linked to height or weight
- IR preferred for patients weighing < ___ kg due to limitied low dose availability of long acting stimulants
- avoid giving dose too late in the day
- late afternoon symptoms may require __ acting formulation
- dont use 2 different stimulants (can use 2 diff dosage forms of the same stimulant)
- 16
- long
special considerations
Mydayis (age ___ - ___ )
Daytrana (methylpenidate) - apply ___
Vyvanse (lisdexamfetamine)
- ___ that is converted to dextroamphetamine
Jornay PM
- take dose in the evening between ___ - ___
13-17
patch
prodrug
6:30-9:30
stimulant adverse effects
alpha 2 agonists
guanfacine is a ___ substrate
alonidine
3A4
must be tapered if d/c to avoid rebound HTN
atomoxetine
___ substrate
___ based
2D6
weight
