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integrated studies in mental health > ADHD RANDOM > Flashcards

ADHD RANDOM Flashcards

1
Q

What are the common side effects of Guanfacine?
Answer:

A

tiredness or fatigue
headache
abdominal pain
dry mouth

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2
Q

What is the mechanism of action of Guanfacine?
Answer:

A

Guanfacine is an agonist at post-synaptic α2A adrenoceptors on dendritic spines of PFC pyramidal neurons. It inhibits cAMP-mediated opening of HCN and KCNQ (inhibitory) channels, increases PFC synaptic connectivity and neuronal firing, and improves working memory and regulates attention, cognitive performance, and behavioural inhibition.

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3
Q

What are the common side effects of Atomoxetine?
Answer:

A

The common side effects of Atomoxetine include a small increase in blood pressure and heart rate, nausea and vomiting, stomach aches, trouble sleeping, dizziness, headaches, and irritability. However, it is linked to suicidal thoughts and liver damage.

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4
Q

What is the mechanism of action of Lisdexamfetamine?
Answer:

A

Lisdexamfetamine is an inactive prodrug that is active only after being converted by the body into dextroamphetamine + L-lysine (essential amino acid). The mechanism of action of Dextroamphetamine is that it is an optical isomer of amphetamine, which has at least three mechanisms of action: substrates for monoamine transporters DAT and NET, causes TAAR1 to phosphorylate DAT, and enters the presynaptic monoamine vesicle causing release of NA and DA towards the synapse.

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5
Q

What are the common side effects of Methylphenidate?
Answer:

A

a small increase in blood pressure and heart rate
loss of appetite, which can lead to weight loss or poor weight gain
trouble sleeping
headaches
stomach aches
feeling aggressive, irritable, depressed, anxious or tense

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6
Q

What are the pharmacotherapeutic management options for ADHD according to NICE guidelines?
Answer:

A

The first-line pharmacotherapeutic management option for ADHD in children aged 5 years and over and young people is Methylphenidate. The first-line option for adults is Lisdexamfetamine or Methylphenidate.

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7
Q

What are the three kinds of ADHD presentations?
Answer:

A

The three kinds of ADHD presentations are Combined Presentation, Predominantly Inattentive Presentation, and Predominantly Hyperactive-Impulsive Presentation.

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8
Q

What are the criteria for diagnosing ADHD in adults?
Answer:

A

To diagnose ADHD in adults and adolescents age 17 years or older, only 5 symptoms are needed instead of the 6 needed for younger children.

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9
Q

How is ADHD diagnosed?
Answer:

A

Symptoms of hyperactivity/impulsivity and/or inattention should meet DSM-5 or ICD-10 diagnostic criteria, cause at least moderate psychological, social and/or educational or occupational impairment, be pervasive, occurring in two or more important settings, and include an assessment of the person’s needs, coexisting conditions, social, familial, and educational or occupational circumstances and physical health.

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10
Q

What is the prevalence of ADHD globally?
.

A

Answer: The prevalence of ADHD globally ranges between 2% and 7%, with an average of around 5%

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11
Q

What are attention skills?

A

Answer: Attention skills are behavioural and cognitive processes of selectively focusing on specific tasks or information, and ignoring other perceivable information.

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12
Q

What is ADHD?

A

Answer: ADHD is a chronic childhood behavioural disorder characterised by developmentally inappropriate attention skills, hyperactivity and impulsivity.

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13
Q

What is the most commonly used diagnostic criteria for ADHD?

A

DSM-5.

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14
Q

What are the requirements for ADHD symptoms to meet the ICD-10 diagnostic criteria?

A

Symptoms must be present in two or more settings.
Symptoms must cause significant social, academic or occupational impairment.
Symptoms must not be better explained by another mental disorder.

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15
Q

How many symptoms of hyperactivity-impulsivity must be present for adolescents age 17 and older and adults to meet DSM-5 criteria for ADHD?

A

Five or more symptoms.

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16
Q

How many symptoms of inattention must be present for adolescents age 17 and older and adults to meet DSM-5 criteria for ADHD?

A

Five or more symptoms.

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17
Q

What are the five presentations of ADHD according to DSM-5?

A

Combined Presentation (both inattention and hyperactivity-impulsivity symptoms).
Predominantly Inattentive Presentation (only inattention symptoms).
Predominantly Hyperactive-Impulsive Presentation (only hyperactivity-impulsivity symptoms).
Unspecified Presentation (symptoms not meeting criteria for any of the above).
Other Specified Presentation (symptoms do not fit any of the above, but there is a reason for not fitting them).

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18
Q

What are the four criteria that ADHD symptoms should meet according to DSM-5?

A

Symptoms should cause moderate psychological, social, or educational or occupational impairment.
Symptoms should be pervasive and occur in two or more important settings.
Assessment of the person’s needs, coexisting conditions, and physical health should be included.
Symptoms should not be better explained by another mental disorder.

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19
Q

What is the ICD-10 diagnostic criteria for ADHD?

A

Either hyperactivity and impulsivity or inattention symptoms, or both, must be present for at least 6 months and be inappropriate for developmental level.

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20
Q

How many symptoms of hyperactivity-impulsivity must be present for a child up to age 16 to meet DSM-5 criteria for ADHD?

A

Six or more symptoms.

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21
Q

How many symptoms of inattention must be present for a child up to age 16 to meet DSM-5 criteria for ADHD?

A

Six or more symptoms.

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22
Q

What is the DSM-5 criteria for ADHD diagnosis?

A

Symptoms of inattention and/or hyperactivity-impulsivity that interfere with functioning or development.
Symptoms should be present before age 12 and persist for at least 6 months.

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23
Q

What is the effect of atomoxetine on neurotransmitters in ADHD?

A

A: Atomoxetine inhibits the reuptake of norepinephrine by binding to the norepinephrine transporter, increasing norepinephrine and dopamine levels in the prefrontal cortex.

24
Q

What is the role of the locus coeruleus noradrenergic system in ADHD?

A

A: The locus coeruleus noradrenergic system is the major source of noradrenaline in the brain and is involved in optimal cognitive task performance.

25
Q

How does methylphenidate affect the brain in ADHD?

A

A: Methylphenidate inhibits transporters for both noradrenaline and dopamine, increasing their synaptic levels and activity in the prefrontal cortex.

26
Q

Which neurotransmitter receptors are associated with ADHD symptoms?

A

A: The dopamine transporter (DAT), DRD4, DRD5, TAAR1, MAOA, COMT, DBH, SERT, 5HT1B, TPH2, and ADRA2A receptors.

27
Q

Which neurotransmitter pathways are associated with ADHD
What is the contribution of genes to ADHD?

A

A: ADHD is familial and highly heritable (74%), arising from the combination of many gene variants.

28
Q

Which neurotransmitter pathways are associated with ADHD symptoms?

A

A: Dopamine, noradrenaline, and serotonin pathways.

29
Q

What changes in brain network activity are seen in ADHD?

A

A: Deficits in attentional and motivational network activity, leading to deficits in response inhibition, vigilance, working memory, and planning.

30
Q

What is the role of the mesocorticolimbic dopamine pathway in ADHD?

A

A: The mesocorticolimbic dopamine pathway is involved in hyperactivity and impulsivity in ADHD.

31
Q

What brain regions are affected in ADHD?

A

A: Prefrontal cortex and posterior parietal cortex, which are involved in executive functions, attention, and planned movements.

32
Q

How do deficits in the noradrenergic system affect attention in ADHD?

A

A: Deficits in the noradrenergic system result in reduced norepinephrine modulation of prefrontal cortex neurons, leading to deficits in attention.

33
Q

First-line medication for children and young people with ADHD according to NICE guidelines:

A

Methylphenidate.

34
Q

Second-line medication for children and young people with ADHD according to NICE guidelines:

A

Lisdexamfetamine.

35
Q

Third-line medication for children and young people with ADHD according to NICE guidelines:

A

Dexamfetamine.

36
Q

First-line medication for adults with ADHD according to NICE guidelines:

A

Lisdexamfetamine or Methylphenidate.

37
Q

Fourth-line medication for children and young people with ADHD according to NICE guidelines:

A

Atomoxetine or Guanfacine.

38
Q

Second-line medication for adults with ADHD according to NICE guidelines:

A

Dexamfetamine.

39
Q

Third-line medication for adults with ADHD according to NICE guidelines:

A

Atomoxetine.

40
Q

Medication for ADHD that inhibits transporters for both noradrenaline and dopamine, increasing synaptic levels of both neurotransmitters:

A

Methylphenidate.

41
Q

Atomoxetine.

A

Medication for ADHD that binds to norepinephrine transporter (NET), inhibiting the reuptake of norepinephrine and increasing NA levels in PFC:

42
Q

Medication for ADHD that requires metabolism to release the active ingredient, dextroamphetamine:

A

Lisdexamfetamine.

43
Q

What are the non-pharmacological treatment options for ADHD?
Answer:

A

Non-pharmacological treatment options for ADHD include behavioral therapy, psychoeducation, and lifestyle changes such as exercise and improved sleep hygiene.

44
Q

What is behavioral therapy in the context of ADHD?
Answer:

A

Behavioral therapy involves working with a mental health professional to develop strategies to manage symptoms of ADHD. This may include learning organizational and time management skills, improving social skills, and addressing emotional regulation.

45
Q

What is psychoeducation in the context of ADHD?
Answer:

A

Psychoeducation involves learning about ADHD and its impact on daily life, as well as strategies for managing symptoms. This may involve individual or group therapy, and may include family members or caregivers.

46
Q

What lifestyle changes can help manage ADHD symptoms?
Answer:

A

Exercise, improved sleep hygiene, and a healthy diet can help manage symptoms of ADHD. Limiting caffeine intake and avoiding alcohol and drugs is also recommended.

47
Q

What lifestyle changes can help manage ADHD symptoms?
Answer:

A

Exercise, improved sleep hygiene, and a healthy diet can help manage symptoms of ADHD. Limiting caffeine intake and avoiding alcohol and drugs is also recommended.

48
Q

What are some pharmacological treatment options for ADHD?
Answer:

A

Medications commonly used to treat ADHD include stimulants such as methylphenidate and amphetamine, as well as non-stimulant medications such as atomoxetine and guanfacine.

49
Q

How do stimulant medications work to treat ADHD?
Answer:

A

Stimulant medications increase the levels of dopamine and norepinephrine in the brain, which can help improve attention, focus, and impulse control.

50
Q

How do non-stimulant medications work to treat ADHD?
Answer:

A

Non-stimulant medications work by increasing the levels of norepinephrine in the brain, which can help improve attention and focus. They may also have an impact on other neurotransmitters such as dopamine and serotonin.

51
Q

What are the potential side effects of ADHD medications?
Answer:

A

Side effects of ADHD medications may include decreased appetite, trouble sleeping, headaches, and stomach aches. Rarely, more serious side effects such as heart problems or psychosis may occur.

52
Q

What is titration in the context of ADHD medication management?
Answer:

A

Titration involves starting with a low dose of medication and gradually increasing the dose until the desired effect is achieved. This helps minimize side effects and find the optimal dose for each individual.

53
Q

How often should medication management be reviewed for ADHD?
Answer:

A

Medication management should be reviewed regularly, typically every 3-6 months, to assess efficacy, side effects, and overall treatment goals. Adjustments to medication or dosage may be necessary.

54
Q

What are some common side effects of ADHD medications?
Answer:

A

Common side effects of ADHD medications include loss of appetite, trouble sleeping, headaches, stomach aches, and irritability.

55
Q

What are some school interventions for ADHD?
Answer:

A

School interventions for ADHD may include accommodations such as extra time on assignments, preferential seating, and frequent breaks.

56
Q

What is parent training for ADHD?
Answer:

A

Parent training involves teaching parents how to better manage their child’s behaviour and develop effective parenting strategies to help manage their child’s ADHD symptoms.

57
Q

What is cognitive behavioural therapy for ADHD?
Answer:

A

Cognitive behavioural therapy focuses on helping children and adults with ADHD identify and change negative thought patterns and behaviours that contribute to their symptoms.

integrated studies in mental health (20 decks)

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