behavior and mental health Flashcards
colic
3 weeks to 3 months
>3 hrs per day
>3 days per week
>3 weeks duration
how much crying is normal up to 6 wks old
2 hours per day
how much crying is normal after 6 wks
3 hrs per day
age for breath holding spell
6-18 months
assoc with breath holding spells?
iron def anemia
not causative, but treatment reduces frequency of spells
when head banging is concerning
after 4 years
if associated with developmental delay
when biting is concerning
after 3 years
- redirect, remove reinforcement, time out
when to intervene on thumb sucking
after age 4 - then risk of malocclusion
management of phobias
desensitization
CBT
ADHD dx criteria
inattentiveness, impulsivity, +/- hyperactivity
- before age 12
- in 2+ settings
- impairs functioning
- for >6 months
risk factors for ADHD
- maternal tobacco and alcohol use
- lead
- low BW
- prematurity
- IUGR
pathways affected in ADHD
decreased activity in dopa and noradrenergic pathways
organic factors that can mimic ADHD
- visual or hearing deficits
- lead
- thyroid dysfn
- previous neuro damage
- medications: phenobarb, antihistamines
- fragile X, FAS, Williams syndrome
relative contraindications for ADHD medications
- young age/small size
- heart conditions
- psych conditions
- seizures
stimulant effects on other meds
- increase concentrations TCAs and seizure meds
SEs of stimulants
- usual stuff (tachycardia, insomnia, etc)
- unmasking tic symptoms
- isolated motor tics may occur and is usually transient
non stimulant ADHD meds
- atomoxetine (norepi uptake inhib)
- clonidine and guanfacine
atomoxetine contraindications
- not w/in 2 weeks of MAO inhibitors
- caution in patients with cardiac conditions or albuterol therapy
atomoxetine SEs
- GI
- fatigue, dizziness
- sedating - give at bedtime
first line agent for depression in children
fluoxetine (only FDA approved medication)
- could also use citalopram or sertraline
fluoxetine SEs
- headache, insomnia, GI upset
- inhibition of CYP450
amitryptiline contraindications
- seizures
- cardiac disorders
- MAO inhibitors in past 14 days
amitryptiline SEs
- anticholinergics
- monitor EKG, BP, and CBC
- urine may turn blue/green
conduct disorder
severe behavioral concerns that impinge on the rights of others or violate age-appropriate social rules
