ADHD Flashcards
ADHD def’n
‘a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development…. and negatively impacts directly on social and academic/occupational activities’
GIve 3 adverse outocmes associated with ADHD
educational problems (resulting in low rates of high-school graduation and completion of postsecondary education) [6], difficult peer relationships [7] and increased rates of motor vehicle accidents, accidental injuries, and substance misuse
3 RF’s for persistence of ADHD into adulthood
combined inattention/hyperactivity, increased symptom severity, comorbid major depressive or other mood disorder, high comorbidity (>3 additional DSM disorders), parental anxiety, and parental antisocial personality disorder [11].
3 RF’s for ADHD
in utero exposure to alcohol or tobacco [18] and low birth weight (<2,500 g) [19][20]. Hypoxic–anoxic brain injury [21], epilepsy disorders [22], and traumatic brain injury
5 parts of clinical process in diagnosis of ADHD
- Several visits
- Detailed history (prenatal, perinatal, medical, mental health)
- dev/behav hx
- fam medical and mental health hx
- review report cards
- obtain standardized behavioural scales taht eval DSM5
…DON’T Do: lab tests, psych testing
for adhd dx, sx must be present before what age?
12
for adhd dx, sx must be present for how long?
> 6 mos
5 DDX for ADHD
"SLO IT" like SLOW IT DOWN: Sleep disorder Learning D/O ODD Intellectual disability Tic D/O
Learning disorder Sleep disorder Oppositional defiant disorder Anxiety disorder Intellectual disability Language disorder, mood disorder, tic disorder, conduct disorder Autism spectrum disorder Developmental coordination disorder
4 syndromes prevalent in ADHD?
Fragile X
Turner
TS
NF1
also 22q11
5 disorders co-morbid with ADHD?
CO-AD’S
OCD *ODD *CD bipolar disorder tic disorders substance use disorders *DCD= dev coordination d/o *Specific learning d/o *ASD Eating disroder
3 parts to med exam for ADHD
physical, neuro, dysmorpohology assessments
Give 5 non pharm intervention for ADHD
DOC’s Do’s:
- Daily Report Card
- Organizational skills training
- Classroom management
- Social skills training
- Diet
Also: psychoeducation, exercise, PBT
trial a given stimulant for how long before determining not working?
2-4 weeks
two stimulants?
dextroamphetamine
methylphenidate
drug holidays in adhd not good for whom?
those with risk-taking behaviours or struggling with peer interactions or “at risk for poor outcomes”
which type of stimulant is hardest to take recreationally?
extended release
is it ok if adhd patient has appetite suppression at lunch? at dinner?
lunch ok; dinner not ok
2 suitable drugs to start for as first chioce older kids iwth adhd?
vyvanse (amphetamine/dextroamphetamine);concerta= MPH
