ADD/ADHD Flashcards
Describe the mechanism by which stimulant medications are beneficial in ADD/ADHD.
The problem in ADD/ADHD is the brain cannot organize the multitude of sensory information that is coming in. Stimulants activate the parts of the brain responsible for organizing sensory input.
By what age is ADD/ADHD typically diagnosed and what is required for diagnosis?
Usually presents by age 7 and must have impairment across multiple settings.
What is the fastest growing drug of abuse in the US and in what setting is abuse most common?
Methylphenidate - especially on college campuses
List three primary symptoms of ADD/ADHD that are improved by methylphenidate.
Inattention, impulsivity, motor over-activity
What control schedule is methylphenidate and what is unique about this?
C-2 –> one of the only non-opioid drugs in C-2
How is methylphenidate dosed and used in the treatment of ADD/ADHD?
Dosing is individualized based on patient response and should be combined with some type of counseling or therapy, like CBT.
How is the efficacy of drug therapy in ADD/ADHD assessed?
Drug holiday –> stop the drug periodically to see if it is still needed.
Describe the advantage and disadvantage of methylphenidate being available in various dosage forms.
Adv: kids have varied methods to which they will adhere to medication forms
Disadv: Different dosage forms may have different potency –> double check the dose when switching dosage forms
What is the advantage and disadvantage of the methylphenidate patch?
Adv: increased adherence and can be applied close to the time when ADD/ADHD is worst for the patient
Disadv: associated with chemical leukoderma –> limited places to place the patch on kids
T/F: Methylphenidate is used to treat depression.
True: can be used as an adjunct in major depression
With what drug class might methylphenidate interact?
MAOIs decrease the metabolism of many of the stimulants
In patients with what conditions would you be cautious in prescribing methylphenidate?
HTN and seizures
What affect will methylphenidate have on appetite and growth?
Decreased appetite and growth
List 5 amphetamine or amphetamine derivative medications (other than methylphenidate) that can be used in the treatment of ADD/ADHD.
Dexmethylphenidate, Dextroamphetamine, Adderall, Dextromethamphetamine, Lisdexamfetamine
Adderall is a combination of what two products?
Amphetamine and dextroamphetamine
T/F: All amphetamine and amphetamine derivatives discussed in class are C-2.
True
What is the only non-stimulant option for treatment of ADD/ADHD discussed in class?
Atomoxetine
Describe the mechanism of action of atomoxetine.
Norepinephrine reuptake inhibitor
What is the control schedule of atomoxetine?
Not controlled –> no abuse potential
When is atomoxetine used in the management of ADD/ADHD?
Second-line –> not as effective as the stimulant medications
What is the off-label use of atomoxetine?
Nocturnal enuresis (bed-wetting)
What are the precautions associated with use of atomoxetine?
Risk of SI
Weight loss –> less so than the stimulants
List 6 medications or classes of medications used as an adjunct in treating ADD/ADHD.
Clonidine TCAs SSRIs Bupropion Venlafaxine Valproic Acid
When might an adjunct to ADD/ADHD treatment be used?
When the patient has issues - severe ADD/ADHD
