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Behavioral Health > ADHD Treatment > Flashcards

ADHD Treatment Flashcards

1
Q

is treatment of ADHD unique?

A

YES! needs to be multimodal and tailored to the specific difficulties of the particular individual

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2
Q

non-pharm treatment for ADHD?

A

psych education with family or individual psychotherapy

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3
Q

symptomatic improvement rate among medications in ADHD

A

75-80%

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4
Q

most commonly used drug class for ADHD?

A

stimulants

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5
Q

methylphenidate

A

ritalin

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6
Q

dextroamphetamine

A

dexedrine

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7
Q

mixed amphetamine

A

adderall

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8
Q

pemoline

A

cylert

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9
Q

dexmethylphenidate

A

foculin

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10
Q

lisdexamfetamine dismesylate

A

vyvanse

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11
Q

types of stimulants

A

short and long acting

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12
Q

unsupported fears with stimulants

A

increased risk of drug addiction, growth failure, tourette’s, or serious emotional disturbance

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13
Q

relative contraindications to stimulants

A

psychosis, seizure d/o, tics, pervasive developmental disorder, CV condition, other meds that may interact with stimulants or substance abuse in the child or family member

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14
Q

MOA of stimulants

A
  • increases both dopamine and norepi
  • increases activity in many areas of the brain & increases inhibition in the neocortex or frontal lobes
  • inhibits unwanted stimuli or responses
  • creating an alert, focused attention
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15
Q

duration of action of stimulants

A
  • rapidly absorbed by the brain

- peak blood levels and effect in 1-3 hours

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16
Q

dosing of ritalin

A

morning and mid-day (shorter acting)

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17
Q

dosing of dexedrine

A

morning and mid-day (shorter acting)

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18
Q

dosing of adderall

A

morning and mid-day (shorter acting)

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19
Q

dosing of cyclert

A

morning (longer acting)

20
Q

significance of foculin

A
  • d-enatiomer of methylphenidate

- aims at maximizing target effects and minimizing side effects

21
Q

significance of vyvanse

A
  • first and only stimulant prodrug
  • therapeutically inactive until metabolized by the body
  • schedule II
22
Q

common side effects of stimulants

A
  • rebound hyperactivity & moodiness (treated by modifying dose or adding another dose)
  • stomach aches, poor appetite
  • headaches
  • tachycardia, increased BP
  • inhibition of growth and weight gain (normalize after d/c med)
  • insomnia
  • less commonly: depression, tics or hallucinations
23
Q

adverse effect of treatment with stimulants

A

abuse potential

24
Q

are severe toxic effects common with stimulants?

A

RARE

25
Q

what is there a risk of if taking cyclert?

A

risk of liver complications (monitor LFTs at the start of treatment and throughout its course)

26
Q

should you give a child with a congenital heart defect a stimulant?

A

NO! may be susceptible to a rare episode of heartbeat irregularities that can cause sudden cardiac arrest

27
Q

atomoxetine

A

strattera

28
Q

MOA of strattera

A
  • norepinephrine reuptake inhibitor
  • NO effect on dopamine
  • inhibits 2D6 enzyme
  • may decrease metabolism of SSRI
29
Q

use of strattera

A

nonstimulant med for ADHD

30
Q

buproprion

A

wellbutrin

31
Q

when should wellbutrin be used to treat ADHD?

A

concomitant depression

32
Q

what is there a risk of with wellbutrin?

A

seizures

33
Q

venlafaxine

A

effexor

34
Q

when should effexor be used to treat ADHD?

A

with concomitant depression

35
Q

when can TCAs and SSRIs be used for ADHD

A
  • patient is harder to manage
  • patient has not had success with stimulants
  • patient has significant coexisting depression, anxiety or tics
36
Q

can TCAs or SSRI be used with stimulants?

A

YES! in low doses of stimulants

37
Q

caution with TCAs and SSRIs

A

more serious side effects`

38
Q

what symptoms do TCAs and SSRIs control in ADHD?

A

overactivity and moodiness, NOT distractability

39
Q

clonidine

A

catapress

40
Q

when should catapress be used?

A
  • concomitant tic disorders
  • may help with sleep problems (take at night)
  • may help overactvity, NOT distractability
41
Q

guanfacine

A

tenex

42
Q

MOA of tenex and catapress

A

alpha agonists

43
Q

can tegretol or depakote be used for ADHD?

A

yes, but 3rd or 4th line

44
Q

can haldol or risperdal be used for ADHD

A

yes, when children have a high degree of aggression or tics

45
Q

a newly diagnosed child with ADHD should have what before initiation of treatment?

A

cardiac workup

  • pt and family history, with special attention to palpitations, fainting or recent difficulties during exercise
  • physical exam with BP and check for heart abnormalities
  • EKG
  • if necessary, pediatric cardiology consult to discuss important findings

Behavioral Health (15 decks)

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