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pharmacy 358 > ADHD > Flashcards

ADHD Flashcards

1
Q

What is the general criteria for ADHD?

A

> 6 sx of inattention for >6 months
6 sx of hyperactivity for >6 months

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2
Q

At what age MUST there be some symptoms by?

A

12

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3
Q

IS it enough to just have symptoms at school OR at home?

A

No needs to be in more than 1 setting

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4
Q

Why are boys more commonly diagnosed?

A

because girls missed cause pinnation goes unnoticed

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5
Q

What neurotransmitters are involved in ADHD?

A

DA and NE

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6
Q

How does neurotransmitters work in ADHD?

A

low DA causes inability to concentrate on dull task
NE dysfunction aids in inattention, mood and arousal

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7
Q

What assessment score used? Which one does teacher use?

A
  1. SNAP-IV 26
  2. CADDRA- teacher
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8
Q

When doe symptoms of ADHD start?

A

preschool

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9
Q

When does diagnosis usually occur for ADHD?

A

School age

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10
Q

When does inattentive become dominant?

A

adulthood

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11
Q

What is the most effective treatment (general)?

A

behaviour AND drug

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12
Q

What non pharm for ADHD?

A

CBT
behaviour parent training, classroom training, peer training

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13
Q

Issue with study comparing atomoxetine and concrete?

A

did not include people that saw no improvement of both drugs or intolerable

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14
Q

MOA of atomoxetine?

A

Norepinephrine reuptake inhibitor

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15
Q

Is atomoxetine or concrete more effective?

A

CONCERTA

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16
Q

If a family wanted a non stimulant for ADHD what do we suggest?

A

atomoxetine

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17
Q

What is drugs better for in ADHD?

A

core ADHD symptoms

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18
Q

What is CBT better for in ADHD?

A

social, behaviours, anxiety

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19
Q

Methylphenidate MOA?

A

inhibits reuptake of DA and NE

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20
Q

AMphetamine MOA?

A

increase release of DA and NE
perhaps also 5HT
inhibits reuptake

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21
Q

Pros of methylphenidate

A

less peripheral activity BUT still some increased heart rate and BP

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22
Q

Does DA or NE have a bigger role in ADHD?

A

DA

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23
Q

MOA of guanfacine and clonidine

A

alpha 2 adrenergic agonist

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24
Q

Why is guanfacine better than clonidine?

A

more selective for 2A receptor= better improvement in behaviour and memory function

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25
Q

Side effects of guanfacine and clonidine?

A

low BP and heart rate

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26
Q

Why are long acting stimulant used?

A

can’t be diverted

27
Q

How much do stimulants help and when to see effect?

A

30-40% sx reduction in 70% of people
see response in 1 week

28
Q

What is an adequate trial of stimulants?

A

3-4 weeks

29
Q

Which is more efficacious, Methylphenidate or amphetamines?

A

equal

30
Q

If you fail methylphenidate what next?

A

amphetamines

31
Q

How beneficial is non stimulants?

A

25-30% reduction in 60% of people

32
Q

When is adequate trial for non stims?

A

6-8 weeks

33
Q

What is role of short acting stimulants?

A

adjuvant to long acting

34
Q

What are third line options for ADHD? Why do they suck?

A

bupropion, clonidine, imipramine, modafinil
suck= not effective s/e bad

35
Q

FIrst line amphetamine EDS option?

A

vyvanse

36
Q

First line covered option?

A

Concerta

37
Q

First line methylphenidate EDS option?

A

biphentin

38
Q

What SR drug IS TERRIBLE?

A

ritalin SR- 8 hour Half life

39
Q

Duration of first line agents?

A

> 12 hours

40
Q

What is special about Vyvanse?

A

prodrug= can’t absue

41
Q

Can you switch to generic if patient is on brand name stimulant?

A

NOOOOOO

42
Q

How much can stimulant decrease height?

A

1-2 cm

43
Q

Contraindications of psychostimulants?

A

severe hypertension, symptomatic cardiovascular disease
mania or psychosis

44
Q

Contraindications of atomoxetine?

A

same as stimulants BUT no for advanced atherosclerosis

45
Q

When is atomoxetine preferred

A

substance abuse, severe anxiety or tic disorders

46
Q

Contraindications of alpha 2?

A

can’t be adherent due to rebound hypertension

47
Q

Why are AP interacting with stims?

A

because they BLOCK dopamine

48
Q

What interactions is there for antihypertensive and stims?

A

may decrease hypotensive effect

49
Q

What interactions is there for SSRI/SNRI and stims?

A

increase toxic effect of AD and risk of serotonin syndrome

50
Q

What is optimal dose of stimulants?

A

Where no increase of drug elicits a further response

51
Q

What drug does not increase BP and HR?

A

Alpha 2

52
Q

Which class has low rate of appetite suppression?

A

Alpha 2

53
Q

What drugs have anticholinergic s/e?

A

ALL

54
Q

Which class doesn’t cause anxiety?

A

alpha 2

55
Q

Which class does not cause dizzy?

A

atomoxetine
alpha 2 -dose related

56
Q

Which class causes irritability?

A

Stims and atomoxetine

57
Q

What ones cause headache?

A

all

58
Q

Which drug doesn’t cause insomnia?

A

Alpha 2

59
Q

Which once does not cause drowsy?

A

Stims

60
Q

Which are good for tics?

A

atomoxetine and alpha 2

61
Q

Which class doesn’t not get skin reactions?

A

Alpha 2

62
Q

Which class has rebound affect of neuro sx?

A

Stims

63
Q

Which class causes decrease in weight?

A

stims and atomoxetine

64
Q

Which class does not cause sex dysfunction?

A

Stims and alpha 2(best)

pharmacy 358 (16 decks)

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