ADHD Flashcards
1
Q
ADHD
A
- Chronic illness
- Need cognitive behavior therapy FIRST
- Believed to be connected to defects in DA system (lack of DA/NE)
2
Q
ADHD Sxs
A
- Inattention
- Hyperactivity
- Impulsivity
Ex:
- Difficulty focusing
- Easily distracted
- Trouble staying still
- Unable to control impulsive behavior
3
Q
Diagnosis Criteria
A
- Sxs must be present before age 12
- Present in 2+ settings
- 6+ sxs must be present for at least 6 months
4
Q
Natural Products for ADHD
A
- Fish oils!
- Melatonin can help with sleep in these patients
5
Q
First-line for ADHD
A
- Concerta, Daytrana, or Ritalin
- Vyvanse
- Adderall XR and IR (usually old)
6
Q
Alternatives for ADHD
A
- 2nd line: Strattera (decreases abuse risk, or after 2-3 meds fail)
- Intuniv - guanfacine (causes sedation)
- Kapvay - clonidine (causes sedation)
7
Q
Sleep Options
A
- Clonidine IR
- Diphenhydramine
- OR Intuniv/Kapvay (less sedating, ER forms)
8
Q
Stimulants
A
- CII: need med guide
- Need to ensure heart is in good condition/not too fast
- Need BP, weight, height, and HR checked at each visit
9
Q
Stimulant Dosing
A
- Titrate dose Q7d
- No need to taper when D/C IF used as directed
- Prefer taking once daily in morning
10
Q
Vyvanse
A
- Capsule form
- Mix in water, orange juice, or yogurt (all others are beads in capsule that go on a small amount of applesauce)
- Has chewable option, not used as much
11
Q
QuilliChew ER
A
- Methylphenidate
- Chewable tablet - can be cut/chewed
- Quillivant XR is a long acting suspension option as well
12
Q
Stimulant Info
A
- Daytrana: place on hip, can lose pigmentation on those skin sites (put on 2 hours before desired effect)
- SE: Nausea, insomnia, HA, dry mouth, blurry vision, irritability, priapism
- New onset psychosis/increases seizure risk
- Consider ECG and monitoring BG/HR
- Monitor height/weight
- CI w/in 14 days of MAOI use
13
Q
Concerta
A
- Methylphenidate
- Small capsules
- CANNOT be opened, crushed, etc
- OROS formulation (combo of IR/ER) - ghost capsule
14
Q
Strattera Box Warnings
A
- Atomoxetine, non-stimulant option
- Suicidal ideation
- Worsening mood
- MAOI use w/in 14 days
15
Q
Atomoxetine Info
A
- Hepatotoxicity
- Priapism
- Do NOT open capsule - irritant
- Can reduce height/weight of children too
- Similar SE to stimulant + sexual dysfunction