ADHD and Medications Flashcards
How long do ADHD symptoms need to be present for prior to diagnosis?
at least 6 months
What are the three types of ADHD?
- Hyperactive/impulse
- Inattentive
- Combined
What assessment tool is available for parents/teachers to use to report ADHD symptoms?
What age range is this assessment tool useful for?
Vanderbilt Assessment Scale
for ages 6-12 yo
Using the Vanderbilt Assessment Scales, to meet criteria for ADHD what 2 criterion must be met between the symptoms and performance sections?
- 6+ (+) responses in hyperactive or inattentive symptoms in “Behaviors” section
- Must have 2 ‘4s’ or 1 ‘5’ in the “Performance” section
What are the two major categories of ADHD medications?
Stimulants and Non-Stimulants
What are the two classes of Stimulants used to treat ADHD?
- Methylphenidates
- Amphetamines
What are the 3 most common methylphenidate medications used to treat ADHD?
- Ritalin
- Concerta
- Focalin
What are the 2 most common amphetamine medications used to treat ADHD?
- Adderall
- Vyvanse
What are the 3 most common non-stimulant medications used to treat ADHD?
- Strattera (atomoxetine)
- Clonidine
- Guanfacines
What is the generic name for Strattera?
Atomoxitine
What is the generic name for Ritalin?
Methylphenidate hydrochloride
What is the generic name for Concerta?
Methylphenidate hydrochloride extended release
What is the generic name for Focalin?
Dexmethylphenidate
Are these stimulants long or short-acting?
Ritalin
Concerta
Focalin
Ritalin - SHORT acting
Concerta - LONG acting
Focalin - SHORT acting
What are the three major side effects of methylphenidate medications?
- decreased appetite
- sleep disturbances
- cardiac
Are these stimulants long or short-acting?
Adderall
Vyvanse
Adderall - SHORT acting
Adderall XR - LONG acting
Vyvanse - LONGEST 1/2 life
Which amphetamine medication is the best for concomitant anxiety symptoms?
Vyvanse
What side effect is commonly seen with amphetamine use?
emotional reactivity
What are two main side effects of non-stimulant ADHD medications?
drowsiness (3-5 days) and dizziness
- alpha 2 agonists
Ritalin (IR) dosing
Children 3-5 yo
Children 6 yo+
3-5: initial 2.5 mg BID, gradually titrate to 7.5 mg BID/TID over 2-4 wks
6+: initial 2.5-5 mg BID, inc. by 5-10 mg/day at weekly intervals
- Max: 2 mg/kg/day
Concerta (XR)
Children 6+ who are methylphenidate-naive
Children 6+ who are switching from IR to XR (4)
Naive: 18mg QD
Not naive:
- 5 mg IR BID/TID –> 18 mg QD
- 10 mg IR BID/TID –> 36 mg QD
- 15 mg IR BID/TID –> 54 mg QD
- 20 mg IR BID/TID –> 72 mg QD
Concerta (XR)
How do dose adjustments occur?
What is the max daily dosing? (age 6-12 vs 12+)
Adjust: inc. by 18 mg/day at weekly intervals
Max dosing:
- 6-12: 54 mg/day
- 12+: 72 mg/day
Focalin (6yo+)
Methlyphenidate naive dosing (IR and XR) vs switching from methylphenidate
Naive:
- IR: 2.5 mg BID, inc. 2.5-5mg/day weekly (Max: 20mg/day)
- XR: 5 mg QD, inc. 5mg/day weekly (Max: 30mg/kg/day)
Switching:
- initial dose: 1/2 methylphenidate dose
Adderall (IR)
3-5 yo dosing vs 6+ yo dosing
3-5: 2.5 mg QD, inc. 2.5mg/day weekly (Max: 40mg/day in 1-2 divided doses)
6+: 5 mg QD/BID, inc. 5 mg/day weekly (Max: 40mg/day)
