ADHD Flashcards
What does ADHD stand for?
Attention Deficit Hyperactivity Disorder
What is ADHD?
Behavioural syndrome characterised by hyperactivity, impulsivity and inattention which can lead to psychological social, educational or occupational impairment.
Most common age group ADHD presents in and when is it commonly pciked up?
3-7 years
may not be recognised until after 7 years
What is the aim of ADHD treatment?
What non-drug treatments are advised?
reduce functional impairment and severity of symptoms, improve quality of life
- Balanced diet, good nutrition and exercise
- Environment - reduce distractions
What is 1st and 2nd (if no improvement after 6 weeks) treatment for ADHD?
Alternative if above don’t work/ 6 weeks trial with each?
- Methylphenidate hydrochloride (Concerta XL)
or
Lisdexamfetamine mesilate (prodrug of Dexamfetamine sulfate)
- Alternative 1st line option
Alternative.
- Atomoxetine (non-stimulant)
If there is a concern with drug misuse..what can be used as 1st line instead?
Atomoxetine
When starting treatment, patients should be monitored for side effects…?
when else should they be monitored?
Observed for: agitation irritability suicidal thinking self harming behaviour unusual changes in behaviour
After a change in dose
What class do ADHD treatments belong to and what is the MoA?
CNS Stimulants
Increase amounts of norepinephrine and dopamine in the brain
What should be monitored in CNS use?
Monitor side effects as well as: Pulse BP psychiatric symptoms appetite weight and height should be recorded at initiation, change in dose and at 6 month intervals
Lisdexamfetamine mesilate
is the pro-drug of…which drug?
When can this drug be used although it is unlicensed.
Dexamfetamine sulfate
can be used if pt is benefitting from Lisdexamfetamine but cannot tolerate its longer duration of effect
Methylphenidate (Concerta XL) a CNS stimulant is used for ADHD &…(not licensed)?
Narcolepsy - chronic sleep disorder - extreme drowsiness in daytime, sudden sleepiness
What’s the dose equivalence between standard release and modified release of methylphenidate?
Standard dose is 15mg = 18mg Concerta XL daily
Monitoring requirements with Methylphenidate?
- Pulse
- Blood pressure
- Psychiatric symptoms
- Appetite
- Height and weight
should be recorded at start of treatment and after dose change and at least every 6 months thereafter.
Can modified release formulation of methylphenidate be swapped? What should the Dr do?
Different
versions of MR preparations may not have
the same clinical effect.
To avoid confusion between
different formulations prescribers
should specify the brand to be dispensed.
Some MR preparations can be opened and sprinkled over applesauce /yoghurt to swallow immediately without chewing…although they have the caution label to swallow whole/do not chew. Which ones are these? (2)
MEDIKINET ® XL
EQUASYM ® XL
