ADHD Flashcards

1
Q

ADHD symptoms

A
  1. Problems with concentration, such as making careless mistakes, difficulty remaining focused, and needing to be more focused.
  2. Avoid tasks that require sustained mental effort, such as reading a book or completing a long assignment, misplace items, and be messy.
  3. 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.
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2
Q

ADHD Assessment

A
  1. The nurse may notice high-level fidgeting activity in the child & behaviors.
  2. Teachers may notice difficulty paying attention, disruptive behavior, and inconsistent or messy assignments.
  3. School nurses may see students in their office repeatedly d/t disruptive behaviors and minor injuries for impulsive behaviors.
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3
Q

ADHD Diagnosis

A

–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.

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4
Q

ADHD: Implementation

A

Interventions:
1. Behavior Modification therapy
2. Parent training
3. School accommodations
4. Pharmacologic agents that address Inattention & hyperactive & impulsive behaviors.

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5
Q

CNS Stimulants

A
  1. ^ The activity of CNS neurons
  2. Enhance neuronal excitation; a few suppress neuronal inhibition.
  3. In sufficient doses, all can cause seizures.
  4. Limited clinical applications.
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6
Q

CNS Stimulants (ADHD tx)

A
  1. Amphetamines
  2. Methylphenidate & Dexmethylphenidate
  3. Methylxanthines
  4. Miscellaneous stimulants
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7
Q

Amphetamines-mechanism of action

A
  1. Release norepinephrine
  2. Release dopamine
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8
Q

Amphetamines Pharmacologic effects

A

-CNS
-Cardiovascular system

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9
Q

Amphetamines Tolerance

A

With regular use, tolerance develops to elevation of mood, suppression of appetite, and stimulation of heart and blood vessels.

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10
Q

Amphetamines Physical dependence

A

Abstinence syndrome with abrupt withdrawal.

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11
Q

Amphetamine Abuse

A

High potential for abuse due to Euphoria.

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12
Q

Amphetamines Adverse effects

A
  1. CNS stimulation
  2. Wt loss
  3. Cardiovascular effects
  4. Psychosis
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13
Q

Amphetamines (Acute Toxicity)

A

-Dizziness
-confusion
- hallucinations
-paranoid delusions
-palpitations-
dysrhythmias
-HTN
-Death is rare
-Fatal overdose: Convulsions, coma, and cerebral hemorrhage

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14
Q

Amphetamine Treatment

A

Hallucinations: Chlorpromazine

HTN: Alpha adrenergic blocker(Phentolamine); Chlorpromazine helps lower BP

Seizures: Diazepam

Acidifying the urine can accelerate Amphetamine excretion.

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15
Q

Amphetamines (therapeutic uses)

A

ADHD

Narcolepsy

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16
Q

Methylphenidate (Ritalin, Metadate, Methylin, Concerta, Daytrana, Biphentin) tx for?

A

ADHD & Narcolepsy

17
Q

ADHD symptoms arise from?

A

Symptoms arise in part from abnormalities in various circuits involving the prefrontal cortex.

18
Q

Dorsolateral prefrontal cortex (ADHD)-matching symptoms to circuits

A

-Problems with sustained attention are linked to inefficient information processing in DLPFC.
-Inactivation of DLPFC can lead to difficulty following through or finishing tasks, disorganization, and trouble sustaining mental effort.
-Tests like n-back are used to measure sustained attention and problem-solving abilities. Participants look at a number on a screen and press a button to indicate the number. Higher n values are correlated with increased difficulty in the test.

19
Q

Dorsal Anterior Cingulate Cortex (dACC) ADHD-matching symptoms to circuits

A

-Problems with selective attention are believed to be linked to inefficient information processing in dACC.
-Inefficient activation of dACC can result in symptoms such as paying little attention to detail, making careless mistakes, not listening, losing, being distracted, and forgetting things.
-Stroop task: An example test requires participants to name the color with which a word is written. If a blue name is written in orange, the color would be orange, not blue.

20
Q

Prefrontal motor cortex (ADHD) matching symptoms to circuits

A

-The prefrontal motor cortex may modulate hyperactivity.
-Common symptoms of hyperactivity in children with ADHD include fidgeting, leaving one’s seat, running/climbing, being constantly on the go, and having trouble playing quietly.

21
Q

The orbitofrontal cortex (ADHD)-matching symptoms to circuit

A

-Impulsivity may be modulated by the orbitofrontal cortex (OFC).
-Examples of impulsive symptoms in ADHD include talking excessively, blurting things out, not waiting one’s turn, and interrupting.

22
Q
A