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Notes/Facts/Brand vs Generics part 3 > Attention Deficit Hyperactivity Disorder > Flashcards

Attention Deficit Hyperactivity Disorder Flashcards

1
Q

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A
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2
Q

ADHD is characterized by symptoms of:

A
  • inattention
  • hyperactivity
  • impulsivity

” patients often have difficulty focusing, are easily distracted, have trouble staying still and are frequently unable to control impulsive behavior.

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3
Q

dopamine is metabolized to _______ and __________.

A

epinephrine and norepinephrine

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4
Q

Cognitive behavioral therapy (using psychotherapy to identify and alter thoughts and feelings, which can lead to a change in behavior), is _______ in managing ADHD.

A

first-line

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5
Q

ADHD medications are considered first line in patients ___________

A

> or = to 6 years old

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6
Q

The DSM-5 Criteria for ADHD are based on an assessment of the primary symptoms,

Inattention:
1)
2)

and/or

Hyperactivity & Impulsivity:
1)
2)

A

Inattention:

1) > or = 6 symptoms (of inattention) for children up to age 16 OR
> or = 5 symptoms for ages 17 years and older

2)* - Symptoms must have been present for at least 6 months and are inappropriate for the developmental level*

Hyperactivity & Impulsivity:

1) > or = 6 symptoms (of hyper/impul) for children up to age 16 OR
> or = 5 symptoms for ages 17 years and older

2)* - Symptoms must have been present for at least 6 months and are inappropriate for the developmental level*

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7
Q

Symptoms of Inatention:

A
  • fails to pay attention
  • has trouble holding attention
  • does not pay attention when someone is talking
  • does not follow through on instructions
  • fails to finish schoolwork
  • has difficulty organizing tasks
  • avoids or dislikes tasks which require mental effort
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8
Q

Symptoms of Hyperactivity & Impulsivity:

A
  • often fidgets or squirms
  • leaves seat unexpectantly
  • runs about when not appropriate
  • unable to play quietly
  • talks excessively
  • blurts out answers
  • has trouble waiting his/her turn
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9
Q

The Following Conditions Must be Met: ADHD DSM-5 Criteria

1)
2)
3)

A

1) Several inattentive or hyperactive-impulsive symptoms were present before age 12 years

2) Symptoms must have been present in 2 or more settings (home, school, work, with friends, or relatives, babysitters);

3) Symptoms interfere with functioning and are not caused by another disorder.

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10
Q

Natural products for ADHD:

A

Fish Oils Polyunsaturated Fatty Acids (PUFAs)

  • supplements were given for 4-16 weeks
  • little evidence that PUFA supplementation provides benefit
  • some limited data of improvement with combined omega 3 and omega 6 supplementation.
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11
Q

_____________ is used to help with sleep onset in individuals taking stimulants.

A

melatonin

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12
Q

___________ formulations are preferred for children.

A

Long-acting

To help maintain more steady symptom control and avoid the need for a dose during the day at school.

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13
Q

Patient-Friendly Formulations For Stimulants:

For young children (and others) who cannot swallow capsules or tablets, what short and long-acting formulations can they use which come in a more convenient dosage form or allow the capsule contents to be place on food?

amphetamine:

amphetamine/dextroamphetamine:

dextroamphetamine:

lisdexamfetamine:

dexmethylphenidate:

methylphenidate:

serdexmethylphenidate:

A

amphetamine:
(Evekeo) - IR ODT
(Dyanavel XR) - ER oral suspension
(Adzenys XR-ODT) - ER ODT
———————————————————————————————
amphetamine/dextroamphetamine:
(Adderall XR) - capsule, contents can be opened and sprinkled on
applesauce.
————————————————————————————————
dextroamphetamine: * products not recommended in children 5 yo and younger.

lisdexamfetamine:
(Vyvanse) - contents can be opened and mixed with water, orange juice or yogurt.
(Vyvanse) - also comes as a long acting chewable tablet.
————————————————————————————————————
dexmethylphenidate:

methylphenidate:
(Ritalin LA) - ER capsule, contents can be opened and sprinkled on applesauce.
(Methylin) - IR oral solution
- IR Chewable tablet
(Quillivant XR) - ER oral suspension
(QuilliChew ER) - ER chewable tablet
(Cotempla XR-ODT) - ER ODT
(Daytrana) - transdermal patch
———————————————————————————————————-
serdexmethylphenidate:

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14
Q
A
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15
Q

Ritalin

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class: stimulant

Indications: ADHD first line

MOA: drug works by blocking the reuptake of norepinephrine and dopamine.

Dosage forms: IR tablet, chewable tablet

Dosing: Start 5mg BID, 30min before breakfast and lunch

Max dose: 60mg/day

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

chewable tablets: contain phenylalanine (avoid in PKU)

Drug-Drug/Food interactions:

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16
Q

Methylin

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms: IR oral solution

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

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17
Q

Concerta

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
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Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms: OROS delivery

Dosing: start 18-36mg daily in the morning

Max dose: Max: 72mg/day

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:
* OROS delivery: the outer coating dissolves fast to provide an immediate relief action, and the rest is slowly released; can see a ghost tablet in stool, harder to crush, which decreases abuse potential.

Drug-Drug/Food interactions:

18
Q

Ritalin LA

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms: ER capsule

Dosing: start 10-20mg daily in the morning

Max dose: Max 60mg/day

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

19
Q

Adhansia XR

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms: ER capsule

Dosing: start 25mg daily in the morning

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

20
Q

Jornay PM

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms: ER capsule

Dosing: start 20mg daily at bedtime**

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

outer coating delays initial drug release 10 hours to allow for evening dose; inner coating controls the slow release of the drug during the day

Drug-Drug/Food interactions:

21
Q

Aptensio XR

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

22
Q

Quillivant XR

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

23
Q

QuilliChew ER

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

24
Q

Cotempla XR-ODT

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

25
Q

Daytrana

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methylphenidate

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:
- loss of pigmentation at application site and areas distant from the application site (can resemble vitiligo), allergic contact sensitization with local reactions (e.g. edema, papules)

Side Effects:
- nausea, insomnia, headache, irritability, blurry vision, dry mouth

Monitoring:

Pearls/Notes:
Apply 2 hours before desired effect (or as soon as child awakens so it starts to deliver prior to school) and remove after 9 hours; alternate hips daily.

Drug-Drug/Food interactions:

26
Q

Focalin

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

dexmethylphenidate

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

27
Q

Azstarys

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

serdexmethylphenidate/dexmethylphenidate (Prodrug)

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

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Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

28
Q

Adderall

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

dextroamphetamine/amphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

29
Q

Adderall XR

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

dextroamphetamine/amphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

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Side Effects:

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Pearls/Notes:

Drug-Drug/Food interactions:

30
Q

Mydayis

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

dextroamphetamine/amphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

31
Q

Adzenys XR-ODT

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
- with amphetamines. Avoid use of acidic foods (juice or Vitamin C) as these can decrease amphetamine levels.
Drug-Drug/Food interactions:

A

amphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

32
Q

Dyanavel XR

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

amphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

33
Q

Evekeo ODT

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

amphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

34
Q

Dexedrine

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

dextroamphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

35
Q

ProCentra

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

dextroamphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

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Monitoring:

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Drug-Drug/Food interactions:

36
Q

Zenzedi

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

dextroamphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

37
Q

Vyvanse

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

lisdexamfetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

38
Q

Desoxyn

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

methamphetamine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

39
Q

Strattera

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

atomoxetine

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

40
Q

Kapvay

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

clonidine ER

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

41
Q

Intuniv

Class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

guanfacine ER

Class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

42
Q
A

Notes/Facts/Brand vs Generics part 3 (19 decks)

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