ADHD Flashcards
Dx for ADHD requires the following DSM-IV criteria: persistent and inappropriate pattern of ___ or ___, symptoms before age ___, impairment in either ___ or ___, interferes w/___ or ___, and symptoms not d/t another ___ condition.
inattention, hyperactivity, 7, school, home, academics, occupation, psychological
ADHD is symptoms that have persisted for at least ___ months to a degree that is ___ and ___ w/developmental level.
6, maladaptive, inconsistent
The 3 forms of ADHD is: ___ which is the most common, ___ ___/___, and ___ ___.
combined, predominately hyperactive/impulsive, predominately inattentive
Predominately hyperactive/impulsive is more likely to be ___, is usually identified ___, and causes ___ behavior.
male, early, disruptive
Predominately inattentive is more likely to be ___, is identified ___, are usually labeled as ___ or ___ and may be r/t ___ or ___.
female, later, lazy, unmotivated, depression, anxiety
Risk factors for ADHD include: ___ birth wt, ___ ADHD, ___ and ___ exposure.
low, parental, cigarette, ETOH
50% of untreated ADHD adults will have a ___ ___/___ disorder at some time in their life.
substance abuse/dependence
Children w/ADHD are at greater risk for early ___ ___, increased ___, ___ ___ pregnancy, school ___, ___, ___, job ___, and decreased rate of ___ HS.
sexual intercourse, STD’s, increased teen, suspension, detention, expulsion, termination, finishing
AAP guideline for dx is: A child ___-___ yrs of age presenting w/___, ___, ___, academic ___, or ___ problems should be evaluated for ADHD.
6-12, inattention, hyperactivity, impulsivity, underachievement, behavior
It needs to be in a combination of settings, such as ___ AND ___.
home, school
ADHD evaluation should include a ___/___ test.
hearing/vision
___ is the most significant piece in an ADHD hx.
prematurity
When assessing for ADHD, assess for ___ behaviors, ___ features like fetal ETOH or fragile X, ___, ___, ___, ___, and ___.
autistic, dysmorphic, tics, thyroid, hearing, vision, neurodevelopment
Evaluation of a child w/ADHD should include assessment of what coexisting conditions?
Oppositional defiant disorder, conduct, disorder, anxiety disorder, depressive disorder
AAP recommendations is that clinicians should recommend ___ medication as appropriate to improve target outcomes in children w/ADHD. If one stimulant does not work at the highest feasible dose, the clinician should recommend ___.
stimulant, another
There are 2 drug categories of ADHD meds and include:
stimulants, nonstimulants
Stimulants include:
methylphenidate, dextroamphetamine, amphetamine salts
nonstimulants include:
selective norepinephrine reuptake inhibitors (SNRI’s), alpha 2 agonists
Dextroamphetamine/amphetamine salts are ___ the dose of MPH or ___.
half, Ritalin
Methlphenidate meds include:
concerta, focalin, focalin XR, metadate-CD, ritalin, ritalin-LA, methylin, daytrana,
Dexamphetamine meds include:
dexedrine, dexadrine spansules, dextrostat
Amphetamine mix meds include:
adderall, adderall-XR
Stimulants are considered schedule ___ drugs d/t potential for ___. They can not be ___ and may dispense up to a total of ___ days. Orders cannot be transmitted via ___. Some states require a ___-___ security Rx blank.
II, abuse, refilled, 90, telephone, tamper-resistant
Nonstimulants include:
atomexetine (Straterra), bupropion (Wellbutrin), venlafaxine (Effexor), clonidine (Catapres), guanfacine (Tenex), modafinil (Sparlon)
Things to know about stimulant meds: start ___ and go ___, ___ dosage is half of ___ dosage, do a ___ phone follow up, ___ follow up if < 12 yrs, ___ follow up if > 12 yrs.
low, slow, DMP, MPH, monthly, quarterly, biannual
Assess ___ rating scales and adjust stimulant dose appropriately.
behavior
During initiation and titration of stimulant medication, evaluate child every ___-___ weeks and monitor every ___-___ months
2-4, 1-4
Blackbox warnings for Stimulants include: ___ symptoms, ___ symptoms, and risk for ___ ideation.
cardviovascular, psychological, suicidal
It is appropriate for an ADHD referral when the child is less than ___ yrs old, there are comorbid ___ conditions, comorbid ___ or ___ conditions, or lack of response to a ___ trial of medication.
6, psychiatric, neurologic, medical, controlled
___ are DOC for most children w/ADHD.
Stimulants
___ is the most common “mental diagnosis” in children
ADHD
Stimulants should not be used in children, adolescents, and adults w/known structural ___ ___. This is a blackbox warning w/stimulants.
cardiac abnormalities
Screen all pts for family hx of ___ ___ or ___ anomalies. No routine ___ is necessary.
sudden death, cardiac, EKG
Stimulants may produce emergent ___ or ___ symptoms like hallucinations, delusions, or mania in children and adolescents.
psychotic, manic
___ can be used not only to tx depression but also for the tx of ADHD as well. These drug categories include:
Antidepressants, SSRI’s, SNRI’s, tricyclic antidepressants, monoamine oxidase inhibitors (MAOI’s)
Atomoxetime (aka ___) is an ___ and can be used for the tx of both ___ and ___. The black box warning that goes along w/this med is risk of ___.
Straterra, SNRI, depression, ADHD, suicidality
FDA urges close observation of pediatric pts who are started on an ___. There should be ___ face-to-face visits w/pts and caregivers during the first ___ wks of tx, then every other week for the next ___ wks. Visit at ___ wks. Pt information form to be given at pharmacy w/each ___.
antidepressant, weekly, 4, 4, 12, prescription
If using medication combinations, important to ___ to a specialist.
refer
Next to marijuana, ___ drugs are the most commonly abused drugs.
psychotherapeutic
Stimulant medications include ___, ___, and the ___ ___.
methylphenidate, dextroamphetamine, amphetamine salts
True or false: the public is likely to have preconceived ideas about stimulant medications.
True
___ meds contain an FDA warning concerning sudden ___ ___.
Stimulant, cardiac death
