ADHD Flashcards
ADHD symptoms
- Problems with concentration, such as making careless mistakes, difficulty remaining focused, and needing to be more focused.
- Avoid tasks that require sustained mental effort, such as reading a book or completing a long assignment, misplace items, and be messy.
- Children may fidget, run, or climb when not appropriate, interrupt conversations, or talk excessively about a single topic.
It’s important to note that while children may exhibit more physical symptoms like fidgeting, running, or climbing inappropriately, adults may present with more internal restlessness than physical impulsivity.
ADHD Assessment
- The nurse may notice high-level fidgeting activity in the child & behaviors.
- Teachers may notice difficulty paying attention, disruptive behavior, and inconsistent or messy assignments.
- School nurses may see students in their office repeatedly d/t disruptive behaviors and minor injuries for impulsive behaviors.
ADHD Diagnosis
–Teacher & School psychologists may recommend eval for dx.
–PCP may dx & tx uncomplicated ADHD.
- If symptoms worsen, a referral to a Psychiatric Nurse Practitioner or Child Psychiatrist is recommended.
- Questionnaires and the VANDERBILT ASSESSMENT SCALES are used to identify children with ADHD and measure treatment progress.
ADHD: Implementation
Interventions:
1. Behavior Modification therapy
2. Parent training
3. School accommodations
4. Pharmacologic agents that address Inattention & hyperactive & impulsive behaviors.
CNS Stimulants
- ^ The activity of CNS neurons
- Enhance neuronal excitation; a few suppress neuronal inhibition.
- In sufficient doses, all can cause seizures.
- Limited clinical applications.
CNS Stimulants (ADHD tx)
- Amphetamines
- Methylphenidate & Dexmethylphenidate
- Methylxanthines
- Miscellaneous stimulants
Amphetamines-mechanism of action
- Release norepinephrine
- Release dopamine
Amphetamines Pharmacologic effects
-CNS
-Cardiovascular system
Amphetamines Tolerance
With regular use, tolerance develops to elevation of mood, suppression of appetite, and stimulation of heart and blood vessels.
Amphetamines Physical dependence
Abstinence syndrome with abrupt withdrawal.
Amphetamine Abuse
High potential for abuse due to Euphoria.
Amphetamines Adverse effects
- CNS stimulation
- Wt loss
- Cardiovascular effects
- Psychosis
Amphetamines (Acute Toxicity)
-Dizziness
-confusion
- hallucinations
-paranoid delusions
-palpitations-
dysrhythmias
-HTN
-Death is rare
-Fatal overdose: Convulsions, coma, and cerebral hemorrhage
Amphetamine Treatment
Hallucinations: Chlorpromazine
HTN: Alpha adrenergic blocker(Phentolamine); Chlorpromazine helps lower BP
Seizures: Diazepam
Acidifying the urine can accelerate Amphetamine excretion.
Amphetamines (therapeutic uses)
ADHD
Narcolepsy