ADHD

Question 1

What is the general criteria for ADHD?

Answer 1

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

Question 2

At what age MUST there be some symptoms by?

Answer 2

12

Question 3

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

Answer 3

No needs to be in more than 1 setting

Question 4

Why are boys more commonly diagnosed?

Answer 4

because girls missed cause pinnation goes unnoticed

Question 5

What neurotransmitters are involved in ADHD?

Answer 5

DA and NE

Question 6

How does neurotransmitters work in ADHD?

Answer 6

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

Question 7

What assessment score used? Which one does teacher use?

Answer 7

1. SNAP-IV 26
2. CADDRA- teacher

Question 8

When doe symptoms of ADHD start?

Answer 8

preschool

Question 9

When does diagnosis usually occur for ADHD?

Answer 9

School age

Question 10

When does inattentive become dominant?

Answer 10

adulthood

Question 11

What is the most effective treatment (general)?

Answer 11

behaviour AND drug

Question 12

What non pharm for ADHD?

Answer 12

CBT
behaviour parent training, classroom training, peer training

Question 13

Issue with study comparing atomoxetine and concrete?

Answer 13

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

Question 14

MOA of atomoxetine?

Answer 14

Norepinephrine reuptake inhibitor

Question 15

Is atomoxetine or concrete more effective?

Answer 15

CONCERTA

Question 16

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

Answer 16

atomoxetine

Question 17

What is drugs better for in ADHD?

Answer 17

core ADHD symptoms

Question 18

What is CBT better for in ADHD?

Answer 18

social, behaviours, anxiety

Question 19

Methylphenidate MOA?

Answer 19

inhibits reuptake of DA and NE

Question 20

AMphetamine MOA?

Answer 20

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

Question 21

Pros of methylphenidate

Answer 21

less peripheral activity BUT still some increased heart rate and BP

Question 22

Does DA or NE have a bigger role in ADHD?

Answer 22

DA

Question 23

MOA of guanfacine and clonidine

Answer 23

alpha 2 adrenergic agonist

Question 24

Why is guanfacine better than clonidine?

Answer 24

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

Question 25

Side effects of guanfacine and clonidine?

Answer 25

low BP and heart rate

Question 26

Why are long acting stimulant used?

Answer 26

can't be diverted

Question 27

How much do stimulants help and when to see effect?

Answer 27

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

Question 28

What is an adequate trial of stimulants?

Answer 28

3-4 weeks

Question 29

Which is more efficacious, Methylphenidate or amphetamines?

Answer 29

equal

Question 30

If you fail methylphenidate what next?

Answer 30

amphetamines

Question 31

How beneficial is non stimulants?

Answer 31

25-30% reduction in 60% of people

Question 32

When is adequate trial for non stims?

Answer 32

6-8 weeks

Question 33

What is role of short acting stimulants?

Answer 33

adjuvant to long acting

Question 34

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

Answer 34

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

Question 35

FIrst line amphetamine EDS option?

Answer 35

vyvanse

Question 36

First line covered option?

Answer 36

Concerta

Question 37

First line methylphenidate EDS option?

Answer 37

biphentin

Question 38

What SR drug IS TERRIBLE?

Answer 38

ritalin SR- 8 hour Half life

Question 39

Duration of first line agents?

Answer 39

>12 hours

Question 40

What is special about Vyvanse?

Answer 40

prodrug= can't absue

Question 41

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

Answer 41

NOOOOOO

Question 42

How much can stimulant decrease height?

Answer 42

1-2 cm

Question 43

Contraindications of psychostimulants?

Answer 43

severe hypertension, symptomatic cardiovascular disease mania or psychosis

Question 44

Contraindications of atomoxetine?

Answer 44

same as stimulants BUT no for advanced atherosclerosis

Question 45

When is atomoxetine preferred

Answer 45

substance abuse, severe anxiety or tic disorders

Question 46

Contraindications of alpha 2?

Answer 46

can't be adherent due to rebound hypertension

Question 47

Why are AP interacting with stims?

Answer 47

because they BLOCK dopamine

Question 48

What interactions is there for antihypertensive and stims?

Answer 48

may decrease hypotensive effect

Question 49

What interactions is there for SSRI/SNRI and stims?

Answer 49

increase toxic effect of AD and risk of serotonin syndrome

Question 50

What is optimal dose of stimulants?

Answer 50

Where no increase of drug elicits a further response

Question 51

What drug does not increase BP and HR?

Answer 51

Alpha 2

Question 52

Which class has low rate of appetite suppression?

Answer 52

Alpha 2

Question 53

What drugs have anticholinergic s/e?

Answer 53

ALL

Question 54

Which class doesn't cause anxiety?

Answer 54

alpha 2

Question 55

Which class does not cause dizzy?

Answer 55

atomoxetine alpha 2 -dose related

Question 56

Which class causes irritability?

Answer 56

Stims and atomoxetine

Question 57

What ones cause headache?

Answer 57

all

Question 58

Which drug doesn't cause insomnia?

Answer 58

Alpha 2

Question 59

Which once does not cause drowsy?

Answer 59

Stims

Question 60

Which are good for tics?

Answer 60

atomoxetine and alpha 2

Question 61

Which class doesn't not get skin reactions?

Answer 61

Alpha 2

Question 62

Which class has rebound affect of neuro sx?

Answer 62

Stims

Question 63

Which class causes decrease in weight?

Answer 63

stims and atomoxetine

Question 64

Which class does not cause sex dysfunction?

Answer 64

Stims and alpha 2(best)