Attention deficit hyperactivity disorder (ADHD) Flashcards
Define ADHD according to the DSM-V.
A persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development*
*like in all paeds conditions there has to be an element of developmental delay
How many DSM-5 features of ADHD have to be persistent in those 16yrs or younger and >17 years? How long for?
16 years and younger = 6 peristent features
17 years and above = 5 persistent features
DSM-5: “symptoms of hyperactivity-impulsivity /inattention have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level”
How common is ADHD?
- 2.4% affected
- boys> girls (4:1)
- most diagnosis between age of 3 -7 years
- possible genetic component
List 5 hyperactivity/impulsivity symptoms in ADHD.
List 5 inattention symptoms in ADHD.
How common is ADHD?
x2 more common than autism
2.4% of UK population affected
M>F 4:1
possible genetic component
When is ADHD usually diagnosed?
Between ages of 3-7 years
Once a child with suspected ADHD first presents, what is the next course of action?
10 week “watch and wait” period to see if symptoms change or resolve
If they persist refer to secondary care paediatric specialist or to CAMHS
When is drug therapy given for ADHD?
Only as a last resort and to those ages 5 years and older
Mild/moderate symptoms should be treated with training/education programmes
Which medications are used to treat ADHD in a child?
1st line - methylphenidate 6 week trial
2nd line - lisdexamfetamine
3rd line (if lisdexfetamine is not tolerated due to SE) - dexamfetamine
What is the MOA of methylphenidate?
CNS stimulant - dopamine/norepinephrone reuptake inhibitor
What are the side effects of methylphenidate?
Abdominal pain, nausea, dyspepsia
What should be monitored on methylphenidate in children?
Height and weight every 6 months
What are the first line options for ADHD in adults?
Methylphenidate or lisdexamfetamine (switch between them to see which one works)
What should be checked before starting ADHD medication?
ECG as all drugs are potentially cardiotoxic - refer to cardiologist if there is any significant FH of cardiac conditions
