Central Nervous System - ADHD Flashcards
what is first line tx of ADHD in 5+ children?
methylphenidate
what is second line tx of ADHD in 5+ children?
lisdexamfetamine only if 6wk trial at max dose doesnt work
if children 5+ with ADHD cannot tolerate longer duration what is the tx?
dexamfetamine
what is third line tx of ADHD in 5+ children?
if child is intolerant to both 1st + 2nd line give either atomxetine or guanfacine
what is first line tx of ADHD in adults?
methylphendiate or lisdexamfetamine
if adult cannot tolerate first line tx to ADHD what do you give?
dexamefatamine
what is third line tx of ADHD in adults?
atomextine
what are s/e of atomextine?
- QT prolongation
- hepatotoxicity
- suicidal ideation
what preparation is preferred for atomextine and why?
- MR brand specific
- due to pharmacokinetic profile
- convivence increase adherence
what class of drug is methylphenidate?
CNS stimulant
What are s/e of methylphenidate/lisdexamfetamine/ dexamfetamine?
- inc BP
- tachycardia + arrhythmias
- behaviour/mood changes
- drowsiness + sleep disorders
- low appetite
- growth retardation
- weight loss
What needs to be monitored in methylphenidate/lisdexamfetamine/dexamfetamine?
- pulse
- BP
- psychiatric symptoms
- weight
- appetite
how often does weight need to be monitored in methylphenidate?
initation * dose adjustments * 6MT
what does lisdexamfetamine/ dexamfetamine overdose cause?
- wakefulness
- excessive activity
- paranoia
- hallucinations
- hypertension
followed by: - exhaustion
- convulsions
- hyperthermia
- coma
