ADHD Drugs Flashcards
What are the executive function?
reasoning, inhibiting behaviors, organizing, problem solving, planning
What is the role of stimulant medications?
increase NE and DA present in synpases of prefrontal cortex
What happens if you overdose prefrontal cortex?
inadequate function - dose titrate
What is the goal of ADHD medication?
normalize prefrontal cortex functioning, increase functioning to a normal level w/o overstimulating
What are the two catagories of stimulant ADHD meds?
Methylphenidate
Dexamphetamine
What is IR?
immediate release, tablets, liquid
What is XR?
extended release, capsule, liquid
What is SR?
sustained release, capsule
What is CR?
controlled release
When do you not give ADHD stimulant drugs?
before age 6
What on comes as OROS?
osmotic release oral system - Concerta
What is the patch form?
daytrana
What are the most common side effects of ADHD stimulant drugs?
appetite suppression
Anxiety
Insomnia
What is least common side effects of ADHD stimulant drugs?
HA, increase BP, psychosis
What are the medications for ADHD?
stimulant, nonstimulant, divalproex, alpha agonists, antidepressants
What is MC long acting methylphenidate?
Metadate, Ritalin LA, Methylin Concerta
What are the long acting dexmethylphenidate?
Focalin
What is rarely used stimulant that is only available as short acting?
dextroamphetamine
What are the mixed amphetamine salts?
Adderall, Adderall XR - 2x more potent as methylphenidate
What is lisdexamphetamine?
Vyvanse - prodrug
What is amphetamines are twice as potent as?
methylphenidate
What are the improved effects of stimulants?
improved focus, cognition, attention, memory, inhibitory control
What is the gold standard for assessing medication performance?
math testing
What is the goal of stim meds?
once daily dosing
What drug is a nonstimulant?
Atomoxetine (Strattera)
What is atomoxetine?
Norepinephrine reuptake inhibitor
What does atomoxetine?
bad alone, better with stimulant combo
How long does atomoxetine take to work?
2-3 weeks with gradual increasing dose
What do you have to do with atomoxetine require?
taking the pill whole
What are the most commonly used alpha 2 adrenergic agoinst?
clonidine, kapvay, Guanfacine, Intuniv
What is clonidine?
short acting and taken at night to help sleep
What is some issue concerns?
Many medications will have a cost at the pharmacy of about $200 per month
Insurance may offset some of this cost
Prior authorization often required
Some drug companies offer coupon plans
Why do you start dosing low for ADHD?
This reduces the chance for a serious side effect
Allows the child to experience the medication without being overwhelmed
Minimizes side effects initially
Many side effects will subside after the first few weeks on medication and may not return when the dose is increased gradually
What are some comorbid conditions for ADHD?
Anxiety
Obsessive compulsive disorder
Depression
Oppositional defiant disorder
Bipolar
Conduct disorder
Drug addiction Learning disability
