ADHD

Question 1

CHILDREN 5 AND OVER

Answer 1

METHYLPHENIDATE

Question 2

If not tolerated within 6 weeks

Answer 2

use lisdexamphetamine
It causes prolonged duration of side effects so if that’s an issue, use dexamphetamine

Question 3

Children Intolerant to both

Answer 3

use atamoxetine or guanfacine(ADHD)

Question 4

Guanfenacine

Answer 4

used otc for coughs

Question 5

Grosofluvin

Answer 5

CYP enzyme inducer

Question 6

Adults- what is second line?? And what are its major side effects???

Answer 6

1)methyl or lis first line (dexamphetamine if can’t tolerate long duration of action)
2)atomoxetine 2nd line - causes QT prolongation,hepatoxicity and suicidal ideations)

Question 7

Modified release preps

Answer 7

preferred because of their pharmacokinetic profile,convenience and improved adherence

Question 8

Modified release

Answer 8

prescribed as brand only

Question 9

Methylphenidate can cause…. And what monitoring is in place???

Answer 9

• CNS stimulant
  
  • Excitement of the sympathetic nervous system- High blood pressure, tachycardia and arrhythmias
  • Behaviour and mood change, drowsiness and sleep disorders
  • Decreased appetite, growth retardation and weight loss
  • Monitor pulse, bp , psychiatric,Height,weight at initiation and following adjustments then 6 monthly

Question 10

Lisdexamphetamine and dexamphetamine

Answer 10

Similar toxicity and side effects to methylphenidate

Question 11

Overdose- lis and dex

Answer 11

• Causes:wakefulness, excessive activity,paranoia and hallucinations+ hypertension
  
  • Followed by exhaustion, convulsions,hyperthermia and coma

Similar monitoring to methylphenidate