ADHD Flashcards
What is the first line treatment of ADHD for a child aged 5 and over
Methylphenidate
What do you do if methylphenidate doesn’t reduce symptoms of ADHD in a child aged 5 and over
If a 6 week trial of methylphenidate at the maximum tolerate dose doesn’t reduce symptoms then you switch to LISDEXAMFETAMINE
(Dexamfetamine used if cannot tolerate longer duration if lisdexamfetamine)
What do you give if the child is intolerant to both methylphenidate and lisdexamfetamine
Atomoxetine or guanfacine
What is the adult prescribing pathway for ADHD
1) use methylphenidate or lisdexamfetamine (dexamfetamine if patient can’t tolerate long durations of action
2) Atomoxetine (Causes QT prolongation, Hepatotoxicity and suicidal ideation)
Why are MR Preps preferred for Adults with ADHD
Because if their pharmacokinetic profile, convenience and improved adherence
MR preps should be prescribed as brand only
What is methylphenidate
CNS stimulant
What are the side effects of methylphenidate
High blood pressure, tachycardia and arrhythmias
Behaviour/ mood changes, drowsiness and sleep disorder
Decreased appetite, growth retardation and weight loss
What monitoring is required for methylphenidate
Monitor pulse, blood pressure, psychiatric symptoms, appetite, weight and height at initiation, following dose adjustments then 6 monthly
What are the side effects of lisdexamfetamine and dexamfetamine
Similar side effects to methylphenidate
What are the symptoms of an overdose of lisdexamfetamine and dexamfetamine
Two phases of causes then followed…
Causes: wakefulness, excessive activity, paranoia, hallucinations and hypertension
Followed by: exhaustion, convulsions, hyperthermia and coma
What are the monitoring requirements for lisdexamfetamine and dexamfetamine
Similar monitoring to methylphenidate
