ADHD - Block 3 Flashcards
What is the most common neurobehavioral disorders of childhood?
ADHD
What are the characteristcs of ADHD?
An ongoing pattern of inattention and/or hyperactivity impulsitivity that interferes with functioning
* typically from a lack of D and NE
What are the neurotransmitters that contribute to alertness, focus, though, and effort?
Dopamine and NE
Diagnosis of ADHD are made by using ___?
DSM5
Who qualifies for ADHD evaluation?
Ages 4-18 who present with academic or behavioral problems and sx of inattention, hyperactivity, or impulsivity
What is the criteria for an ADHD diagnosis?
- Sx/behaviors that have persisted ≥6 months in 2 or more settings
- <17 years require 6 or more sx
- > 17 years require 5 or more symptoms
- Sx must be present prior to 12
- Sx must interfere with functioning and not caused by another disorder
What are inattentive sx?
- Misplace items
- Sidetracking by unimportant stimuli
- Forgets daily activities
- Lacks ability to complete schoolwork or follow instructions
- Inability to do tasks that requires concentration
- Poor listening skills
What are hyperactive sx?
- Squirms or fidgets
- APpears to be driven by a motor
- Incapable of staying seated
- Overly talkative
What are impulsive sx?
- Difficulty waiting their turn
- Interrupts other conversations
- Blurts out answers
How are other cormorbities that display similarities to ADHD?
Emotion/behavioral: Az, depression, sustance use disorder
Developmental: dyslexia
What are the ADHD classifications?
- Inattentive premonimant with no hyperactive/impulse past 6 months
- Hyperactive/impulse predomninat with no inattentive criteria for past 6 months
- Combo: both inattentive and hyperactive/impulse
What is the tx for ages 4-5 YO?
1st line: parent training in behavioral management (PTBM) for 6 months
* Methyphenidate
Tx for 6YO and older?
Any FDA approved ADHD med + behavioral interventions
Nonpharm for preschool?
PTBM
CLassroom management
Non pharm for adolescents?
- Break up tasks
- Structured scheduled
- Planners
What aspects are parents trained in for behavior therapy?
- Positive communication
- Psitive reinforcement
- Structure and discipline
Pharm for children ≥6YO?
First-line: stimulants (methylphenidate, amphetamine)
2nd line: (atomoxetine, viloxazine, guanfacine, clonidine ER)
Alt: Bupropion
Stimulants
MOA, BBW, CI, Warning
MOA: Block reuptake of NE and D and inhibit MOA
BBW: High potential for abuse and dependene
CI: Don’t use within 14 days of MOAIs -> hypertensive risk
Warning: Increase HR and BP -> CV events
* Loss in appetite -> decrease child’s growth
* Serotonin syndrome risk
* Exacerbate preexisitng psychosis
* Increase seizure risk
* Priapism
What is the difference betwen IR and ER/XR/LA stimulants?
IR: B-TID, higher risk of diversion and abuse
Long: QD, preferred in children to avoid dosing at school, less diversion and abuse
What Methylphenidate brand is given as an OROS?
Concerta
Administration info for Daytrana?
Apply 2 hr before desired effect, remove after 9 hr