ADHD Flashcards
what is ADHD characterized by?
motor hyperactivity, restlessness, inattention, poor planning and impulsivity. In the adolescent period and into adulthood, motor restlessness often abates but the fidgetiness, restlessness and other symptoms persist.
What pregnancy-related factors increase the risk of ADHD?
Premature birth, low birth weight, and smoking during pregnancy.
What environmental factors may be related to ADHD?
Exposure to lead and other toxic substances, as well as infections in the brain.
How can parenting influence the development of ADHD?
Neglect, abuse, and being in multiple foster homes may contribute, but family function is not generally believed to be a cause.
Key Neurotransmitters Involved in ADHD?
Dopamine: Regulates attention, motivation, and reward processing.
Norepinephrine: Affects attention and arousal.
Serotonin: Influences mood and behavior.
Why are individuals with ADHD more at risk, physiologically, to substance abuse?
Impulsivity: Leads to experimentation with substances.
Disinhibition: Reduced self-control increases likelihood of substance use.
Reward Sensitivity: Drives individuals to seek immediate gratification.
Which stimulant medications are offered in extended-release form for ADHD?
Common extended-release stimulants include methylphenidate (e.g., Concerta, Ritalin LA) and amphetamine-based medications (e.g., Adderall XR, Vyvanse).
Why is extended-release medication useful in the case of ADHD?
Extended-release formulations provide a sustained effect throughout the day, reducing the need for multiple doses and helping to manage symptoms more consistently.
Which anti-depressant can be helpful in the case of depression and mild to moderate ADHD?
Bupropion (Wellbutrin) is an anti-depressant that can be beneficial for individuals with both depression and ADHD.
How does treating ADHD reduce criminality and driving mortality rates?
Effective treatment of ADHD improves impulse control and attention, which can lead to better decision-making, reduced risk-taking behaviors, and a lower likelihood of engaging in criminal activities or traffic accidents.
What factors might lead to recommending a stop or change in dosage of ADHD medication for adults?
Ineffectiveness: Lack of significant symptom improvement after several weeks.
Adverse Effects: Unacceptable side effects (e.g., anxiety, insomnia, cardiovascular issues).
Patient Preference: Concerns or preferences expressed by the patient regarding the medication.
Co-occurring Conditions: Emergence of new psychiatric or medical conditions.
Substance Abuse Concerns: Signs of misuse or dependence on the medication.
Compliance Issues: Consistent non-compliance with the medication regimen.
Monitoring Parameters: Concerning trends in routine monitoring (e.g., blood pressure).
Why are individuals with ADHD more at risk, physiologically, to substance abuse?
Physiological Mechanisms
Dysregulated Dopamine Pathways:
ADHD is associated with dysregulation in dopaminergic systems, which also play a critical role in the brain’s reward pathways. This dysregulation may increase the propensity to seek external substances (like drugs or alcohol) that stimulate dopamine release and provide a sense of reward.
Executive Function Deficits:
ADHD is marked by challenges in executive functions, such as impulse control, emotional regulation, and decision-making. These deficits make individuals more likely to engage in risk-taking behaviors, including experimenting with substances.
Consider how impulsivity and disinhibition contribute to social problems and substance abuse?
Impulsivity:
Impulsivity, a hallmark symptom of ADHD, leads to a preference for immediate gratification over long-term benefits. This can manifest as substance use to achieve quick pleasure or stress relief without consideration of the consequences.
Disinhibition:
Difficulty with behavioral inhibition increases vulnerability to peer pressure, particularly in social settings where substance use is normalized. Disinhibition also heightens the risk of poor decision-making, such as overindulging or mixing substances.
Social Problems:
Impulsivity and disinhibition can cause strained relationships, difficulties in maintaining employment or academic success, and social isolation. These stressors may lead to substance use as a coping mechanism.
what are the 3 types of ADHD?
IHC
inattentive
hyperactive-impulsive
combined
what is the DX criteria for inattentive ADHD?
6 or more (INATTENTION) that have persisted for 6 months that is inconsistent with developmental level, negatively impacts social, academic, occupational:
Attention difficulty
Trouble listening
Tasks: avoid/dislike or reluctant
Easily distracted
Necessary things lost
To finish is hard: does not follow through on instructions
Is Forgetful:
Organization is lacking
No concern w/ details
DX criteria for hyperactive-impulsive ADHD?
> 6 symptoms for >6 months to a degree that is maladaptive and inconsistent with the developmental level: RUN FIDGET
Runs/ restless
Uninhibited in conversation
No quiet play
Fidgets
Interrupts
Difficulty waiting
Go - often on the go
Evacuates seat
Talks excessively
