ADHD disorder and meds Flashcards
ADHD
– Persistent pattern of inattention, hyperactivity,
and impulsiveness
–pervasive and inappropriate for developmental level.
–In at least 2 settings for at least 6 months before age 12.
—-work, social, or educational
* THREE TYPES:
* HYPERACTIVITY-IMPULSIVITY TYPE
* INATTENTIVE TYPE
* COMBINED TYPE
hyperactive impulsivity type symptoms
HYPERACTIVITY BEHAVIORS
* Often fidgets; moves feet; squirms in seat; can’t sit still
* Leaves seat before excused
* Runs about/climbs excessively or at inappropriate times
* Difficulty playing quietly (e.g. Board games)
* Is often “on the go” or often acts as if “driven by a motor”
* Often talks excessively/ non-stop talkers
IMPULSIVITY BEHAVIORS
* Often blurts answers before questions finished; speaks before thinking
* Often interrupts or intrudes on others (Butts into conversations or games)
* Problem waiting for his/her turn
inattentive type symptoms
- Does not give attention to details or makes repeated careless mistakes
- Trouble keeping attention on tasks or activities
- Often does not seem to listen when spoken to directly
- Does not follow through with completion of task/activity
- Often has trouble organizing activities
- Avoids, dislikes doing tasks that involve mental effort
- Loses things, distracted, or forgetful
- Easily bored
- Disorganized
What is the best treatment for ADHD?
Behavioral management + FDA approved meds = best results
other non medication treatments for ADHD?
emphasizes self-regulation, social functioning, concentration, attention & focus
- Parent management training (PMT)
- Increasing problem solving skills and coping mechanisms
- Group therapy: 8-12 weekly sessions with trained therapist to aid in behavior changes at home and in the classroom
- NOTE: play therapy & CBT not as effective as treatments above for ADHD
How do stimulants help ADHD?
- Improve attention and FOCUS
- Decrease hyperactivity
Are stimulants weight sensitive?
No, start at low dose and work your way up
What are the long acting stimulants that last 8-12 hours?
There are 4
dextroamphetamine/amphetamine ( Adderall is amphetamine
salts)
(Daytrana, Metadate CD, Ritalin LA, Concerta)
— capsule can be opened and sprinkled
lisdexamfetamine (Vyvanse)
dexmethylphenidate (Focalin XR, Focalin)
methylphenidate
(Daytrana, Metadate CD, Ritalin LA, Concerta)
—patch may be worn, may cause permanent skin discoloration
—flexibility in dose depending on time worn, usually 9 hours,
continues to be in system after patch is removed for a few
more hours
—Ritalin LA is also a capsule that can be opened and sprinkled
on food
What are the 2 long acting stimulants that come as capsuled that can be opened and sprinkled?
methylphenidate (Ritalin LA)
dextroamphetamine/amphetamine (Mydayis)
What are the 2 intermediate acting stimulants for ADHD?
dextroamphetamine —alone without/amphetamine
(Dexedrine, Zenzedi, ProCentra)
methylphenidate
(Ritalin SR, Methylin ER, Metadate ER)
What are the short acting stimulants for ADHD?
methylphenidate (Ritalin)
dexmethylphenidate (Focalin)
dextroamphetamine (Dexedrine)
amphetamine sulfate - ?
ONLY ONE APPROVED by FDA for kids 3-6 years old
dextroamphetamine - no amphetamine
(Dexedrine, Zenzedi, ProCentra)
Methylphenidate in general
long acting - Daytrana, Metadate CD, Ritalin LA, Concerta
—— capsule can be opened and sprinkled
—— patch
intermediate - Ritalin SR, Methylin ER, Metadate ER
—— methylin comes in liquid form
short acting - Ritalin
—— crushed or chewed
What are the side effects of too much stimulant for ADHD?
Child appears dull or overly restricted
(Treat by decreasing dose or changing to different medication)
What are the SE for stimulants used for ADHD?
check vitals at each visit for
– tachycardia or bradycardia
– hypertension
– weight – decreased appetite, stomachaches, diarrhea
Ask about –subjective
– headaches
– trouble getting to sleep
– jitteriness, nervousness, restlessness
– social withdrawal
— dry mouth, unpleasant taste
May need to adjust med dose or try a different medication
