ADHD Flashcards
What is the triad of difficulties in ADHD?
innatention
hyperactivity
impulsivity
What is the criteria for the difficulties in ADHD?
developmentally inappropriate
long standing from age 5
pervasive across settings - home, school, work
impairing functioning
What genetics predisposes to ADHD?
hyperactivity aggregates in families
60% chance that offspring of adults with ADHD will also have it
15% increased risk between siblings that have it
What pathways are involved in ADHD?
dopamine and serotonin transporter genes involved
What perinatal factors can contribute to ADHD?
use of alcohol and tobacco prematurity and perinatal hypoxia short or long labour foetal distress ecclampsia forceps delivery
What psychosocial factors can contribute to ADHD?
marital discord low social class large family size marital disorder parental criminality
What is seen in the brain in patients with ADHD?
underactive frontal lobe - responsible for reasoning, impulse control etc
higher concentration of dopamine transporters
reduction of norepinephrine and serotonin
What is the ADHD diagnostic criteria for children?
6 or more symptoms of inattentiveness and/or
6 or more symptoms of hyperactivity and impulsiveness
present before age of 5
reported by school and parents - seen in clinic
symptoms get in the way of daily life
What is the ADHD diagnostic criteria for adults?
5 or more symptoms of inattentiveness and/or
5 or more symptoms of hyperactivtiy and impulsiveness
historical concerns since early age
moderate effect on differentareas of their lives
How do you treat children with ADHD?
parent training social skills training sleep and diet help behavioural classroom management specific educational interventions
How do you treat adults with ADHD?
1st line - stimulants eg methylphenidate, dexamfetamine, lisdexamfetamine
2nd line - SNRI - atomoxetine
3rd line - alpha agonist - clonidine, quanfacine
4th line - antidepressants and antipyschotics
What is the mode of action of the stimulant Methyphenidate?
increase dopamine by blocking its transporter
What is the mode of action of the stimulant Dexamphetine?
increase dopamine by blocking its transporter and increases extracellular norepinephrine and possible serotonin
