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Pharm 2 > ADHD and narcolepsy > Flashcards

ADHD and narcolepsy Flashcards

1
Q

describe ADHD

A
  • chronic condition including attention difficulty, hyperactivity and impulsiveness
  • usually diagnosed between 3 and 7 years of age
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2
Q

describe the pathophysiology of ADHD

A
  1. most common psychiatric disorder in children
  2. dysfunction in the frontal lobe and subcortical structures
  3. highly heritable, neurobiological disorder partially attributed to dopamine and norepinephrine transport dysfunction in the brain
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3
Q

what are some clinical manifestations of ADHD

A

hyperactivity:
- fidgeting
- squirming in their seats
- excessive running or climbing when it dangerous or inappropriate

impulsivity:
- impatience
- blurting out answers
- frequently interrupting others

inattention:
- messy work
- careless mistakes
- appearance of daydreaming

others:
- low self esteem
- strained peer relations

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4
Q

what is narcolepsy

A
  • excessive sleepiness
  • sleep attacks at inappropriate times
  • neurologic sleep disorder, not a result of mental illness or psych probs
  • genetic abnormalities, biologic factors, environmental triggers
  • affects men and women equally
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5
Q

what are some clinical manifestations of narcolepsy

A
  • disturbed nocturnal sleep
  • abnormal daytime sleep pattern
  • excessive daytime drowsiness
  • fatigue
  • cataplexy
  • hypnagogic hallucinations (happens immediately b4 you fall asleep)
  • sleep paralysis
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6
Q

give an example of an amphetamine

A

dextroamphetamine

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7
Q

whats the action of amphetamines (dextroamphetamine)

A

facilitating initiation and transmission of nerve impulses that excite other cells

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8
Q

what are amphetamines (dextroamphetamine) used for

A

management of ADHD and narcolepsy

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9
Q

whats the onset of PO amphetamines (dextroamphetamine)

A

1-5 hour onset

also may cross placenta

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10
Q

whats the black box warning for amphetamines (dextroamphetamine)

A

high abuse potential, misuse may cause sudden death or serious CV events

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11
Q

what are some contraindications of amphetamines (dextroamphetamine)

A
  • CV disease
  • anxiety
  • agitation
  • history of substance use
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12
Q

describe administration of amphetamines (dextroamphetamine)

A
  • take first thing in the morning and last dose 6hrs b4 bedtime
  • take 30-45mins before meals
  • do not crush or chew
  • perform drug holidays as needed to maintain normal growth and development
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13
Q

what are some nursing implications for amphetamines (dextroamphetamine)

A
  • do NOT give with herbals
  • avoid caffeine
  • avoid acidic foods and juices
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14
Q

describe patient education for amphetamines (dextroamphetamine)

A
  • take only as prescribed
  • avoid caffeine and other stimulants
  • get adequate sleep
  • obtain weekly weights
  • these drugs have high abuse potential
  • keep meds locked up
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15
Q

give an example of amphetamine-related drugs

A

methylphenidate

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16
Q

describe the action of amphetamine-related drugs (methylphenidate)

A

acts on the CNS like amphetamines

17
Q

what are amphetamine-related drugs (methylphenidate) used for

A

management of ADHD and narcolepsy

18
Q

whats the onset of PO amphetamine-related drugs (methylphenidate)

A

1-8hr

19
Q

whats the black box warning of amphetamine-related drugs (methylphenidate)

A

risk of drug dependence with amphetamine-related drugs

20
Q

what are some contraindications of amphetamine-related drugs (methylphenidate)

A
  • CV
  • anxiety
  • agitation
  • history of substance use
21
Q

describe administration of amphetamine-related drugs (methylphenidate)

A
  • take first thing in the morning and last dose 6hrs b4 bedtime
  • take 30-45mins before meals
  • do not crush or chew
  • perform drug holidays as needed to maintain normal growth and development
22
Q

what are some nursing implications for amphetamine-related drugs (methylphenidate)

A
  • do not give with TCAs
  • some SSRIs
  • avoid caffeine
  • avoid acidic foods and juices
23
Q

describe patient education for amphetamine-related drugs (methylphenidate)

A
  • take only as prescribed
  • avoid caffeine and other stimulants
  • get adequate sleep
  • obtain weekly weights
  • these drugs have high abuse potential
  • keep meds locked up
24
Q

describe atomoxetine

this is an SNRI

A
  • second line tx for ADHD in children and adults
  • action: inhibits reuptake of norepi
  • low risk of abuse and dependence

black box warning: suicical ideation may occur in children and adolescents with ADHD

25
Q

describe guanfacine

this is a sympatholytic

A
  • antihypertensive drug used to treat ADHD
  • adverse effects include GI and CV
  • may take 2wks to take effect

Pharm 2 (34 decks)

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