ADHD

Question 1

Primary symptoms of ADHD

Answer 1

inattention
hyperactivity
impulsivity

Question 2

first line treatment for ADHD

Answer 2

psychotherapy

pharmacotherapy: stimulants

Question 3

Inattention symptoms

Answer 3

6 or more symptoms for children up to 16 y/o
5 or more for pts 17 and older:

fails to pay attention
does not follow through on instructions
fails to finish schoolwork
difficulty organizing tasks
looses things 
easily distracted

Question 4

Hyperactivity & impulsivity symptoms

Answer 4

6 or more symptoms for children up to 16 y/o
5 or more for pts 17 and older:

fidgets/squirms
can't be seated for long periods of time
talks excessively
has trouble waiting for turns
interrupts others

Question 5

natural product used in ADHD

Answer 5

fish oil

Question 6

ER formulations are preferred in children (t/f)

Answer 6

True

children would require 2nd dose at school for better symptom control

Question 7

Which stimulants are usually 1st line and why?

Answer 7

Methylphenidate

better side effect profile

Question 8

What drugs can be used to help with sleep if pts have trouble sleeping on stimulants

Answer 8

Clonidine IR
benadryl
Intuniv
Kapvay

Question 9

Stimulant MOA

Answer 9

block the reuptake of NE and dopamine

Question 10

Stimulant titration

Answer 10

up titrated every 7 days

Question 11

Stimulants need to be tapered off when stopping (t/f)

Answer 11

False

Question 12

Stimulant boxed warning

Answer 12

Risk for misuse and abuse

Question 13

Stimulant contraindications

Answer 13

w/in 14 days of a MAO inhibitor
history of CV disease
serious anxiety disorder
glaucoma
hyperthyroidism
tourette's (other tic disorders)

Question 14

Stimulant warnings

Answer 14

Severe CV events
Pre-existing psychiartic disorders (incr suicide risk)
Incr risk of seizures
Loss of appetite (decr growth in children)
Risk of serotonin syndrome w/ serotonergic drugs

Question 15

stimulant side effects

Answer 15

nausea
insomnia
HA
irratability
blurry vision dry mouth

Question 16

Ritalin dosage forms

Answer 16

Tab
chewable tab
Solution (Methylin)

Question 17

ER methylphenidate that releases some drug IR and some as ER

Answer 17

Ritalin LA
Aptensio XR
both caps

Question 18

Methylphenidate ER brands

Answer 18

Concerta (OROS tablet)
Metadate ER
Methylin ER

Question 19

Methylphenidate ER caps can be sprinkled onto applesauce and given right away (t/f)

Answer 19

true

Question 20

Qullichew ER

Answer 20

methylphenidate XR chew tab

can be cut in half

Question 21

Quillivant XR

Answer 21

methylphenidate XR suspension
25 mg/ml
shake for at least 10 secs before giving

Question 22

Cotempla XR-ODT

Answer 22

methylphenidate XR ODT

Question 23

Daytrana

Answer 23

methylphenidate transdermal patch

Question 24

Daytrana onset of action

Answer 24

2 hours

Question 25

Daytrana duration of action

Answer 25

9 hours Apply to alternating hips daily

Question 26

General max dose of all methylphenidate formulations

Answer 26

60 mg/day ConcertaL 72 mg/day

Question 27

Focalin

Answer 27

dexmethylphenidate when converting from Ritalin: give 1/2 of methylphenidate dose

Question 28

Evekeo

Answer 28

Amphetamine tab

Question 29

Adzenys ODT

Answer 29

amphetamine ODT

Question 30

Dyanavel XR

Answer 30

amphetamine suspension

Question 31

What foods can decrease levels of amphetamines?

Answer 31

acidic foods/juice, vitamin C

Question 32

Vyvanse

Answer 32

lisdexamfetamine | caps and chewable tab

Question 33

Capsule cannot be opened (t/f)

Answer 33

False | can be opened and mixed with water, yogurt or orange juice

Question 34

Desoxyn

Answer 34

Methamphetamine

Question 35

Strattera

Answer 35

atomoxetine

Question 36

Strattera MOA

Answer 36

selective NE reuptake inhibitor

Question 37

Strattera boxed warnigns

Answer 37

suicidal ideation

Question 38

Strattera main side effects

Answer 38

``` HA insomnia somnolence hypertension, tachycardia dry mouth nausea, abd pain ```

Question 39

Strattera caps can be opened and mixed with liquids (t/f)

Answer 39

False | do not open caps, very irritating to stomach

Question 40

Strattera metabolism

Answer 40

CYP 2D6 substrate

Question 41

Intuniv

Answer 41

Guanfacine ER

Question 42

Intuniv dosing

Answer 42

4 mg max when used with stimulants | 7 mg max when used alone

Question 43

Intuniv metabolism

Answer 43

CYP3A4

Question 44

Kapvay

Answer 44

clonidine ER

Question 45

Kapvay dosing

Answer 45

0.1 mg qHS | Max: 0.4 mg/day

Question 46

alpha-2 agonist side effects

Answer 46

somnolence dizziness HA fatigue Must be tapered: decr dose every 3-7 days to decr chance of rebound HTN, nervousness, anxiety

Question 47

Strattera can cause renal/hepatic damage

Answer 47

Hepatic