ADHD And Dementia

Question 1

Methylphenidate

Answer 1

Short acting and long acting

Ritalin - S
Concerta / focalin - L

Question 2

Amphetamines

Answer 2

Short acting and long acting

Inhibit DA and NA reuptake

Dexedrine
Adderall

Question 3

NE reuptake inhibitors ( atomoxetine )

Answer 3

Atomoxetine ( no drug holidays needed )

Black box : suicidal ideation

Question 4

Centrally acting alpha agonist

Answer 4

Clonidine extended release

Guanfacine extended release

Question 5

Role of pharmacological treatment

Answer 5

Limitations of miseducation treatment

Emphasize behavioral techniques and family dynamics

Efficacy assessed by improvements in performance

Question 6

Adverse effects with CNS stimulants

Answer 6

Insomnia, nervousness, headache , rebound effect, motor tics, mood lability

Question 7

Contraindication with CNS

Answer 7

Anxiety, tension, agitation, MAOI use, glaucoma, CVD

Black box warning : sudden death in pediatric patient cardiac abnormalities

Question 8

Special populations

Answer 8

Not appropriate for geriatrics

Pedi- do not use in children less than 6

Preg : c not reccomended in lactation

Question 9

Goals of therapy for Dementia

Answer 9

• delay progression of s/s
• prolong patient independence
• preserve quality of line
• ease caregiver burden

Question 10

Cholinesterase inhibitor

Answer 10

Aricept, Exelon, Razadyne,

Uses: mild to severe Alzheimer’s
Dosing: titrated to improve tolerability
Precaution: bradycardia , peptic ulcer disease

Question 11

NMDA receptor antagonist

Answer 11

Memantine

Uses: moderate to severe Alzheimer’s disease

AE’s: confusion, sedation, hallucinations, n/v, GI anorexia

Question 12

Behavioral changes associate with dementia

Answer 12

Agitations and aggression, psychosis, anxiety, sleep disturbance, sun-downing, wandering