ADHD Flashcards
what are the types of ADHD?
- Predominant inattentive type
- Predominant hyperactive-impulsive type
- Combined type
what should an individual show to be diagnosed with ADHD?
Must show at least 5 of 9 symptoms for that subtype for at least 6 months
Symptoms interfere with social/ academic/ occupational activities
what are the symptoms of predominantly inattentive ADHD?
- makes careless mistakes
- difficulty sustaining attentions
- fails to follow through on tasks
- forgets things
- easily distracted
what are the symptoms of predominantly hyperactive ADHD?
- fidgets
- always “on the go”
- talks excessively
- has difficulty waiting
- restless
what gender is more likely to be diagnosed with inattentive and which is hyperactive?
inattentive: females
hyperactive: males
what could be the causes of ADHD?
- partially genetics
- exposure to drugs during pregnancy
- premature birth
- acetaminophen (tylenol) exposure in utero
what is a the neurochemistry of ADHD?
- chemical imbalance between DA and NE
hyperactive type: low DA in limbic system
inattentive type: low NE in PFC
what are ADHD treatments?
- adderall 3:1 d-amphetamine: l- amphetamine
- ritaline/concerta
- vyvanse: pro drug, doesn’t do anything until it is metabolized into d-amphetamine
- methedrine/desoxyn: methamphetamine 2nd line treatment
what type of drugs are ADHD treatments?
schedule 2
what is the route of admin of methylphenidate (ritalin)?
oral, nasal, IV
instrumental use: oral
recreational use: snorting crushed pulls
what is the absorption and distribution of methylphenidate (ritalin)?
- Different versions (rapid vs. delayed release) get into blood at different rates*
- Absorbed from GI tract
- Low bioavailability (~30%) due to first pass metabolism & large individual differences
- 15% depot binding in blood plasma proteins
- Readily passes BBB
what is the metabolism of methylphenidate (ritalin)?
broken down in the liver (NOT CYP450 enzymes) into ritalinic acid (inactive metabolite)
what is the excretion of methylphenidate (ritalin)?
- mostly in urine
- first order elimination
- half life depends on formulation (generally, in 2-4 hours but 2-8 hours in children)
what is the pharmacodynamics of methylphenidate?
- blocks NET and DAT
- does not reverse transporters
how long does it take methylphenidate to raise DA levels? how is that different with cocaine?
it takes an hour but when cocaine is inhaled, injected, and snorted, the brain neurochemistry is altered in seconds-minutes
who abuses methylphenidate the most?
young people and college students
what is the abuse compared to cocaine, amphetamines, or meth?
lower abuse when used instrumentally
