ADHD Flashcards
DSM-5 criteria for ADHD for adults
> 5 symptoms in each category for 6 months or longer noticeable in 2 settings with impact on social, academic, occupational functioning
DSM-5 criteria for ADHD for children
6 or more symptoms in each category, age of onset is before 12, noticeable in 2 settings with impact on social, academic, and occupational functioning
Inattention symptoms criteria DSM-5 ADHD (9)
lack of attention to details/careless mistakes
difficulty sustaining attention
does not seem to listen
does not follow through on instructions
difficulty organizing tasks and activities
avoids sustained mental effort
loses and misplaces objects
easily distracted
forgetful in daily activities
DSM-5 criteria for ADHD hyperactivity and impulsivity (9)
fidgetiness squirms in seat
leaves seat frequently
running about feeling restless
excessively loud or noisy
always on the go
talks excessively
blurts out answers
difficulty waiting his or her turn
tends to act without thinking
ADHD is usually a persistent pattern of
inattention OR hyperactivity, impulsivity or both
abnormalities in the fronto-subcortical pathways of ADHD
frontal cortex- abnormalities in the prefrontal cortex such as reduced volume or connectivity
what is one of the primary neural factors contributing to the development of ADHD
dysfunctional prefrontal cortex
Basal ganglia is affected during ADHD and it oversees what functions
motor control, motor learning, executive functions behaviors and emotions
abnormalities of the reticular activating system affect what?
ability to focus, fight or flight response, regulating arousal and sleep-wake transitions
when dopamine levels are lower or dysregulated it can affect the brain’s ability to properly. modulate (3) p336
attention, focus, self control
Low levels of norepinephrine can lead to difficulties with (3)
attention, focus, impulse control
Low serotonin levels have been associated with (3)
impulsivity, emotional dysregulation, and difficulties with sustained attention
DNS mnemonic
Dopamine low
NE low
Serotonin low
Pharmacology management for ADHD 338
stimulants
things to consider before implementing pharmacological interventions for ADHD
cardiac hx before placing a patient on stimulants due to increasing HR BP and increased risk of stroke and heart attack/stroke
What medication is approved for children ages 3 years and older
amphetamines
What medications are approved for children 6 years and older
methylphenidate
Non stimulant choices alpha agonist or alpha 2 adrenergic receptor agonists (2)
Guanfacine and clonidine is FDA approved 6-17 years old with ADHD
SNRI for ADHD
Strattera (atomoxetine) is approved for children 6 and up with ADHD
S/s of stimulant abuse (9)
insomnia
tremors
increased HR BP
agitation
anxiety
irritability
mood swings
elevated moodN
Non-pharmacological management of ADHD
behavioral therapy
CBT with parents
psychoeducation
tx learning disorders
Follow up for monitoring chemical progress over time: (3)
ARS adult self report scale
conners parent and teacher rating scales
vanderbilt adhd diagnostic parent teaching rating scales
abnormalities in the prefrontal cortex can cause what type of ADHD?
inattentive type
wellbutrin can be used for ADHD but it is
off label
if you have patient that has depression and ADHD what medication can treat both
Wellbutrin
If ADHD medication is wearing off too soon for client what do you do?
change to XR or increase the dosing frequency
if parent is becoming anxious with diagnosis for child you should
briefly stop teaching and decrease anxiety without providing false reassurance
Insomnia and stimulant education
last dose should be taken before 6pm
when should clients take ADHD medications
30-45 min before food due to potentially decreasing potency
executive function
cognitive processes such as planning, working memory
problem-solving, how to direct and maintain attention to a task
are all problems that occur from what cotex?
dorsolateral prefrontal cortex
involved in learning
reward
punishment processing
assigning value and response inhibition
are all controlled by what cotex
orbitofrontal
signs of stimulant abuse (7)
insomnia*
tremors*
Increase BP and HR*
Heart palpitations
agitation
anxiety
irritability and mood swings
