ADHD

Question 1

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.

Answer 1

inattention, hyperactivity, 7, school, home, academics, occupation, psychological

Question 2

ADHD is symptoms that have persisted for at least ___ months to a degree that is ___ and ___ w/developmental level.

Answer 2

6, maladaptive, inconsistent

Question 3

The 3 forms of ADHD is: ___ which is the most common, ___ ___/___, and ___ ___.

Answer 3

combined, predominately hyperactive/impulsive, predominately inattentive

Question 4

Predominately hyperactive/impulsive is more likely to be ___, is usually identified ___, and causes ___ behavior.

Answer 4

male, early, disruptive

Question 5

Predominately inattentive is more likely to be ___, is identified ___, are usually labeled as ___ or ___ and may be r/t ___ or ___.

Answer 5

female, later, lazy, unmotivated, depression, anxiety

Question 6

Risk factors for ADHD include: ___ birth wt, ___ ADHD, ___ and ___ exposure.

Answer 6

low, parental, cigarette, ETOH

Question 7

50% of untreated ADHD adults will have a ___ ___/___ disorder at some time in their life.

Answer 7

substance abuse/dependence

Question 8

Children w/ADHD are at greater risk for early ___ ___, increased ___, ___ ___ pregnancy, school ___, ___, ___, job ___, and decreased rate of ___ HS.

Answer 8

sexual intercourse, STD’s, increased teen, suspension, detention, expulsion, termination, finishing

Question 9

AAP guideline for dx is: A child ___-___ yrs of age presenting w/___, ___, ___, academic ___, or ___ problems should be evaluated for ADHD.

Answer 9

6-12, inattention, hyperactivity, impulsivity, underachievement, behavior

Question 10

It needs to be in a combination of settings, such as ___ AND ___.

Answer 10

home, school

Question 11

ADHD evaluation should include a ___/___ test.

Answer 11

hearing/vision

Question 12

___ is the most significant piece in an ADHD hx.

Answer 12

prematurity

Question 13

When assessing for ADHD, assess for ___ behaviors, ___ features like fetal ETOH or fragile X, ___, ___, ___, ___, and ___.

Answer 13

autistic, dysmorphic, tics, thyroid, hearing, vision, neurodevelopment

Question 14

Evaluation of a child w/ADHD should include assessment of what coexisting conditions?

Answer 14

Oppositional defiant disorder, conduct, disorder, anxiety disorder, depressive disorder

Question 15

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 ___.

Answer 15

stimulant, another

Question 16

There are 2 drug categories of ADHD meds and include:

Answer 16

stimulants, nonstimulants

Question 17

Stimulants include:

Answer 17

methylphenidate, dextroamphetamine, amphetamine salts

Question 18

nonstimulants include:

Answer 18

selective norepinephrine reuptake inhibitors (SNRI’s), alpha 2 agonists

Question 19

Dextroamphetamine/amphetamine salts are ___ the dose of MPH or ___.

Answer 19

half, Ritalin

Question 20

Methlphenidate meds include:

Answer 20

concerta, focalin, focalin XR, metadate-CD, ritalin, ritalin-LA, methylin, daytrana,

Question 21

Dexamphetamine meds include:

Answer 21

dexedrine, dexadrine spansules, dextrostat

Question 22

Amphetamine mix meds include:

Answer 22

adderall, adderall-XR

Question 23

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.

Answer 23

II, abuse, refilled, 90, telephone, tamper-resistant

Question 24

Nonstimulants include:

Answer 24

atomexetine (Straterra), bupropion (Wellbutrin), venlafaxine (Effexor), clonidine (Catapres), guanfacine (Tenex), modafinil (Sparlon)

Question 25

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.

Answer 25

low, slow, DMP, MPH, monthly, quarterly, biannual

Question 26

Assess ___ rating scales and adjust stimulant dose appropriately.

Answer 26

behavior

Question 27

During initiation and titration of stimulant medication, evaluate child every ___-___ weeks and monitor every ___-___ months

Answer 27

2-4, 1-4

Question 28

Blackbox warnings for Stimulants include: ___ symptoms, ___ symptoms, and risk for ___ ideation.

Answer 28

cardviovascular, psychological, suicidal

Question 29

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.

Answer 29

6, psychiatric, neurologic, medical, controlled

Question 30

___ are DOC for most children w/ADHD.

Answer 30

Stimulants

Question 31

___ is the most common “mental diagnosis” in children

Answer 31

ADHD

Question 32

Stimulants should not be used in children, adolescents, and adults w/known structural ___ ___. This is a blackbox warning w/stimulants.

Answer 32

cardiac abnormalities

Question 33

Screen all pts for family hx of ___ ___ or ___ anomalies. No routine ___ is necessary.

Answer 33

sudden death, cardiac, EKG

Question 34

Stimulants may produce emergent ___ or ___ symptoms like hallucinations, delusions, or mania in children and adolescents.

Answer 34

psychotic, manic

Question 35

___ can be used not only to tx depression but also for the tx of ADHD as well. These drug categories include:

Answer 35

Antidepressants, SSRI’s, SNRI’s, tricyclic antidepressants, monoamine oxidase inhibitors (MAOI’s)

Question 36

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 ___.

Answer 36

Straterra, SNRI, depression, ADHD, suicidality

Question 37

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 ___.

Answer 37

antidepressant, weekly, 4, 4, 12, prescription

Question 38

If using medication combinations, important to ___ to a specialist.

Answer 38

refer

Question 39

Next to marijuana, ___ drugs are the most commonly abused drugs.

Answer 39

psychotherapeutic

Question 40

Stimulant medications include ___, ___, and the ___ ___.

Answer 40

methylphenidate, dextroamphetamine, amphetamine salts

Question 41

True or false: the public is likely to have preconceived ideas about stimulant medications.

Answer 41

True

Question 42

___ meds contain an FDA warning concerning sudden ___ ___.

Answer 42

Stimulant, cardiac death