ADHD

Question 1

What does ADHD stand for?

Answer 1

Attention Deficit Hyperactive Disorder

Question 2

Three main features of ADHD include:

Answer 2

• Inattention
• Hyperactive
• Impulsive

Question 3

Examples of inattention behaviour?

Answer 3

• Fails to give close attention to details or makes careless mistakes in schoolwork
• Has difficulty keeping attention during tasks or play
• Does not seem to listen when spoken to directly
• Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
• Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
• Often forgetful in daily activities
• Easily distracted

Question 4

Examples of hyperactive behaviour?

Answer 4

• Fidget with hands or feet
• Squirms in seat
• Runs about or climbs in inappropriate situations
• Difficulty playing quietly
• Talks excessively

Question 5

Examples of impulsive behaviour?

Answer 5

• Blurts out answers before questions have been completed
• Interrupts conversations
• Difficulty waiting for their turn

Question 6

If untreated may lead to:

Answer 6

• high incidence of substance misuse (alcohol and/ or cannabis)
• educational difficulties
• relationship problems

Question 7

ADHD diagnosis must follow extensive mental health assessment by a specialist clinician such as:
In addition the diagnosis should follow a full assessment by an

Answer 7

• Paediatrician
• Child Psychiatrist
• Educational +/ or a Clinical Psychologist

Question 8

Onset of ADHD is usually:

Answer 8

Before 3 years old

Question 9

Duration of ADHD is usually

Answer 9

6 months and to a maladaptive level inconsistent with normal development

Question 10

Non pharmacological treatments of ADHD include:

Answer 10

• psychoeducational methods where the education and advise should be based on treatment offered
• parent training/ family centred behaviour therapy
• behavioural interventions (school or pre-school). This will promote social adjustment and reduce hyperactive behaviour

Question 11

Problem with using pharmacological treatment?

Answer 11

Treating symptoms instead of syndromal control

Question 12

Should not assume that drugs are more hazardous at the younger end of spectrum because:

Therefore, prescribing and subsequent titration should be on a ___/___ dosing range

Answer 12

Bioavailability is lower in children because:

• Drug is distributed in larger extracellular fluid
• Rapid metabolism

BUT

Drug also crosses BBB more readily .

-mg/kg.

Question 13

Name two psychostimulant drugs for ADHD

Answer 13

Methylphenidate

Dexamphetamine

Question 14

Name on centrally-acting sympathomimetic used in ADHD

Answer 14

Atomoxetine

Question 15

Pharmacological treatments for ADHD should only be used after _____ _________. AND as part as care package that includes: (3 things)

Answer 15

specialist assessment
educational
psychological
behavioural assessment + intervention

Question 16

Stimulants more affective in treating which feature of ADHD over which other feature?

Answer 16

hyperactivity

inattention

Question 17

Stimulants are said to improve:
Overactivity
Attention span
Impulsivity
Aggression
Social Interaction
BUT what may not improve?

Answer 17

social skills

general academic achievement

Question 18

Methylphenidate not licensed in children

Answer 18

6

Question 19

MOA of methylphenidate?

Answer 19

Inhibits reuptake of monamine NTs (e.g DA) into presynaptic neurone therefore increases DA levels at post synaptic receptor sites

Question 20

If no response after _____ at ______ dose(and with assured compliance) decrement and stop.

Answer 20

1 month

maximum

Question 21

Adverse effects of methylphenidate:

Answer 21

Insomnia
Decreased appetite
Euphoria/ Depression/ Anxiety
Psychosis (rare)

Question 22

Dexamphetamine licensed for children > ___ years

Answer 22

3

Question 23

Which pharmacological agent for ADHD has limited abuse potential?

Answer 23

Atomoxetine

Question 24

Atomoxetine is licensed for patients aged:

Answer 24

6+ years, adolescents and adults

Question 25

Atomexetine MOA:

Answer 25

Highly selective inhibitor of the pre-synaptic NE transporter. It has minimal effect on serotonergic or dopaminergic transporters.

Question 26

Psychological response of ADHD is monitored using what rating scale?

Answer 26

Connors abbreviated scale