Attention deficit hyperactivity disorder

Question 1

what is the first line for children over 5 years old for ADHD?

Answer 1

-methylphenidate

Question 2

what is treatment for ADHD if methylphenidate isn’t tolerated after 6 weeks? for children

Answer 2

use lisdexamfetamine
-can cause prolonged side effects should use dexamfetamine instead

Question 3

what treatment is given to patients who are intolerant to both methylphenidate and lisdexamfetamine? for children

Answer 3

should use atomoxetine or
guanfacine

Question 4

what is the treatment for ADHD first line for adults?

Answer 4

methylphenidate or lisdexamfetamine
-and dexamfetamine
-atomoxetine is 2nd line

Question 5

what are some side effects of atomoxetine?

Answer 5

-QT prolongation, hepatoxicity and suicidal ideation

Question 6

what is special about modified release preparations?

Answer 6

-should only be prescribed as brand only
-its the preferred because of pharmacokinetics profile, convenience and improved adherence

Question 7

what is methylphenidate? side effects

Answer 7

-CNS stimulant
-can cause high blood pressure, tachycardia and arrhythmias
-behaviour/mood changes, drowsiness and sleep disorder
-decreased appetite, growth retardation and weight loss

Question 8

what should be monitored for using methylphenidate?

Answer 8

-monitor pulse, blood pressure, psychiatric symptoms, appetite, weight and height at initiation, following dose adjustments then 6 monthly

Question 9

what are some side effects of lisdexamfetamine and dexamfetmine?

Answer 9

similar to methylphenidate
-CNS stimulant
-can cause high blood pressure, tachycardia and arrhythmias
-behaviour/mood changes, drowsiness and sleep disorder
-decreased appetite, growth retardation and weight loss

Question 10

what is the toxicity pathway for lisdexamfetamine and dexamfetmine?

Answer 10

-patient will go up then down
-will go from wakefullness, excessive activity paranoia, hallucinations and hypertension followed by exhaustion, convulsions hyperthermia and coma