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Therapeutics 3 - Spring 2018 > ADHD/Peds Psych > Flashcards

ADHD/Peds Psych Flashcards

1
Q

what disorder has BOTH multiple motor and 1+ vocal tics present at some time (not always concurrently)

A

tourettes!

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2
Q

what disorder has single or multiple motor or vocal tics present, but not both

A

persistent/chronic motor or vocal tic disorder…

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3
Q

what tic disorders have to be present for more than 1 year

A

tourettes
and
persistent/chronic motor or vocal tic disorder.

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4
Q

what tic disorder is present for less than 1 year

A

provisional tic disorder

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5
Q

onset of tic disorders happen usually before age _____

A

18

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6
Q 
Treating Tic Disorders:
what drug class should be used?
A

antipsychotics

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7
Q

Treating Tic Disorders:

_____ blockade — efficacious 70 - 90%

A

DA

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8
Q

what antipsychotics are used for treating Tic Disorders?

A

haloperidol
aripiprazole
risperidone/paliperidone (highest DA block)
Orap - pimozide (orphan drug0

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9
Q

why is pimozide of concern? (comparing to haloperidol)

A

QT prolongation

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10
Q

why is haloperidol of concern? (comparing to pimozide)

A

more EPS ADEs

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11
Q

common co=morbidity of tourettes

A

ADHD

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12
Q

______ can exacerbate motor/vocal tic symptoms

A

amphetamine based stimulants

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13
Q

what is ODD stand for

A

oppositional defiant disorder

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14
Q

main criteria groups for ODD

A

angry/irrititable mood
argumenative/defiant behavior
vindictiveness

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15
Q

diagnosis for ODD has to last at least ____

A

6 mos

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16
Q

main criteria groups for CD

A

aggression to ppl/animals
destruction of property
deceitfulness or theft
serious violations of rules

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17
Q

how to treat ODD and CD

A

psycosocial tx = 1st line
drugs 1st choice: stimulants or clonidine/guanfacine!!!

1st line is NOT atypical antipsychotics

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18
Q

for ODD and CD: if atypical antipsychotics tx failure happens at _____ weeks — consider ______ or _____

A

2 weeks

typical antipsychotic or mood stabilizer

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19
Q

1st line option for Separation anxiety disorder

A

combo tx: med monotherapy + psychotherapy

1st line drug option = SSRIs

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20
Q

________ is first line tx for Austism Spectrum Disorder

A

behavioral interventions

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21
Q

what drugs can be used for Autism Spectrum disorder

A

typical antipsychotics: haloperidol

atypical antipsychotics: Aripiprazole and Risperidone

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22
Q

what is CD

A

conduct disorder

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23
Q

for Autism spectrum disorder:

typical or atypical antipsychotics are FDA approved for irritability/aggression

A

atypical (Aripiprazole and Risperidone)

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24
Q

for Autism spectrum disorder:

typical or atypical antipsychotics are used to reduce social isolation/improve anger related behaviors, hyperactivity

A

typical (haloperidol)

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25
Q

if a child has issues with repetitive behaviors — what drugs can be used

A

Antipsychotics: haloperidol, risperidone, aripiprazole

divalproex

(SSRIs done commonly but like like no consistent evidence)

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26
Q

what is DMDD

A

disruptive mood dysregulation disorder

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27
Q

atomoxetine has little effect on _______

A

inattention

28
Q

clonidine and guanfacine has modest effect on ________ and ______

A

irritability
and
explosive behavior

29
Q

what are first line tx for DMDD

A

SSRIs and stimulants

30
Q

first line for pediatric depression

A

non pharm:
CBT!!
need group support

31
Q

what antidepressant should be avoided in kids

A

paroxetine

32
Q

what antidepressant can be used down to kids of 8 yo

A

fluoxetine

33
Q

what antidepressant can be used for kids starting at age 12

A

escitalopram

34
Q

for Peds. Bipolar Disorder:

if Bipolar I w/OUT psychosis

A

Li+ = Drug of choice
valproate, CBZ, olanzapine, risperidone, quetiapine too

Add 2nd agent after 4 weeks if needed

35
Q

for Peds. Bipolar Disorder:

if Bipolar I w/ psychosis

A

Li+, Valproate, CBZ WITH any atypical

may consider d/c atypical if remission for 12 - 24 mos

36
Q

for Peds. Bipolar Disorder:

if Bipolar I Depressed

A

1st line Li+

adjunct w/ Li+ do SSRI or bupropion

37
Q

Atypical Antipsychotics and FDA approvals for Peds.:

Aripiprazole

A

bipolar
irritability w/ autism
schizophrenia
tourettes

38
Q

Atypical Antipsychotics and FDA approvals for Peds.:

Asenapine

A

bipolar

39
Q

Atypical Antipsychotics and FDA approvals for Peds.:

lurasidone

A

schizophrenia

bipolar

40
Q

Atypical Antipsychotics and FDA approvals for Peds.:

Olanzapine

A

bipolar

schizo

41
Q

Atypical Antipsychotics and FDA approvals for Peds.:

Paliperidone

A

schizo

42
Q

Atypical Antipsychotics and FDA approvals for Peds.:

quetiapine

A

bipolar

schizo

43
Q

Atypical Antipsychotics and FDA approvals for Peds.:

which one is ONLY schizophrenia

A

paliperidone

44
Q

Atypical Antipsychotics and FDA approvals for Peds.:

which one is ONLY biploar

A

asenapine

45
Q

Atypical Antipsychotics and FDA approvals for Peds.:

which one is for tourettes

A

aripiprazole

46
Q

Atypical Antipsychotics and FDA approvals for Peds.:

which ones are for irritability for autism

A

aripiprazole

risperidone

47
Q

Atypical Antipsychotics and FDA approvals for Peds.:

what is the only drug NOT for schizophrenia

A

asenapine

48
Q

Atypical Antipsychotics and FDA approvals for Peds.:

what is the only drug NOT for bipolar

A

paliperidone

49
Q

which SSRI is hella hella selective for SERT (like a 7000 fold)

A

escitalopram

50
Q

AAP Treatment Guidelines for ADHD:

what do you if pt is 4 - 5 years…?

A

behavioral tx is 1st line!!

can use methylphenidate if behavioral intervention

51
Q

AAP Treatment Guidelines for ADHD:

what do you if pt is 6 - 11 years…?

A

FDA approved sitmulants/atomoxetine/guanfacine/clonidine and or behavioral therapy
(prefer both)

52
Q

AAP Treatment Guidelines for ADHD:

what do you if pt is 12 - 18 years…?

A

FDA approved sitmulants/atomoxetine/guanfacine/clonidine and or behavioral therapy
(prefer both)

53
Q

if getting HA from stimulants — what do you do

A

divide dose
take with food
give analgesic

54
Q

if getting stomach ache from stimulants — what do you do

A

take with food

lower dose if possible

55
Q

if getting irritability/jitteriness from stimulants — what do you do

A

asses for co-morbid condition
reduce dose
consider mood stabilizer or atypical antipsychotics

56
Q

which ADHD drug has a rare ADR of priaprism

A

methylphenidate

57
Q

what ADHD drugs (stimulants or non stimulants) can cause peripheral vasculopathy

A

stimulants!

58
Q

what drug is a part of daytrana patch

A

methylphenidate

59
Q

Daytrana Patch:
patch applied to out side ____
apply ____ hours prior to needed effects
remove after ____ hours

A

side hip
2 hours
9 hours

60
Q

if pt cant tolerate _____ dont use daytrana

A

methylphenidate

bc methylphenidate is daytrana

61
Q

atomoxetine has warning for ______ toxicity

A

liver

62
Q

clonidine or guanfacine is a 3A4 substrate

A

guanfacine!!

63
Q

T or F: Lithium is v effective in ADHD

A

false!!!

good for bipolar

64
Q

ADHD and Bipolar are co-morbid:
_______ has most evidence in helping
________ is commonly used but not as well studied

A

CBZ

valproic acid

65
Q

ADHD and Bipolar are co-morbid:

T or F: atypicals can be used as monotherapy

A

false!!

not ok for ADHD monotherapy

66
Q

Atypical Antipsychotics and FDA approvals for Peds.:

Risperidone

A

bipolar
irritability w/ autism
schizophrenia

Therapeutics 3 - Spring 2018 (20 decks)

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