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Pharmacotherapeutics > Childhood ADHD and other psychiatric illnesses > Flashcards

Childhood ADHD and other psychiatric illnesses Flashcards

1
Q

What is the most common childhood psychiatric disorder (3-5% population)?

A

ADHD

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2
Q

What is the proposed cause of ADHD?

A

Possible genetics, 4-5fold increase if first degree relative; 5-fold increase if sibling.
environment factors, smoking, heavy metals

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3
Q

What is the effect of neurotransmitters in ADHD?

A

Deficiency of norepinephrine and dopamine at synapse in frontal and neostriatial systems.

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4
Q

What are the 3 main symptoms of ADHD?

A

Inappropriate inattention, impulsivity, hyperactivity

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5
Q

This involves not finishing tasks, not seeming to listen, being easily distracted, difficulty concentrating, difficulty sticking to play.

A

inappropriate inattention

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6
Q

This involves acting before thinking, shifting excessively, difficulty organizing work, increased need for supervision, difficulty waiting in lines.

A

impulsivity

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7
Q

This involves excessive running/jumping, difficulty staying seated, excessive movement during sleep

A

hyperactivity

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8
Q

Drugs of choice for ADHD are?

A

CNS stimulants such as methylphenidate, dextroamphetamine

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9
Q

If the patient has no perceived benefit from the medication this is?

A

pharmacodynamic failure

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10
Q

If the patient has some improvement from the medication this is?

A

pharmacokinetic failure

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11
Q

How are short acting CNS stimulants usually dosed?

A

BID to TID to reach daily dose

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12
Q

Which drug is a prodrug of dextroamphetamine and is long acting without requiring a sustained release design?

A

Vyvanse, lisdexamfetamine dimesylate

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13
Q

Headache, decreased appetite, GI complaints, insomnia, exacerbation of tics, delayed growth are side effects of?

A

CNS stimulants

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14
Q

What is the Brand name, initial dose, and max dose of Amphetamine-dextroamphetamine?

A

Adderall
3-5yrs 2.5mg/day ; max 40mg/day
6yrs 5mg/day ; max 40mg/day

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15
Q

What is the Brand name, initial dose, and max dose of dextroamphetamine?

A

Dexedrine, Dextrostat
3-5 yrs 2.5mg/day; max 20mg/day
6 yrs 5mg/day; max 40mg/day

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16
Q

What is the Brand name of dexmethylphenidate?

A

Focalin

17
Q

What is the brand name of methamphetamine?

A

Desoxyn

18
Q

What is the Brand name, initial dose of amphetamine-dextroamphetamine er?

A

Adderall XR

6 yrs 10mg

19
Q

What is the Brand name, initial dose of dextroamphetamine?

A

Dexedrine spansules

6 yrs 5mg

20
Q

What is the Brand name, initial dose of lisdexamfetamine dimesylate

A

Vyvanse

6 yrs 30mg

21
Q

What is the Brand name, initial dose of methylphenidate?

A

Metadate CD/ER, methylin, Ritalin, concerta, daytrana, quillivant XR
6 yrs 20mg
Daytrana 10mg/9 hour
Concerta 18mg

22
Q

This drug is a non-stimulant agent for ADHD, it is a SNRI.

A

Atomoxetine (Strattera)

23
Q

What interact occurs with Atomoxetine?

A

CYP2D6

24
Q

Somnolence and anorexia are side effects of?

A

Atomoxetine

25
Q

What drugs are alpha2 agonist used for ADHD?

A

Clonidine (Catapress, Kapvay)

Guanfacine (Tenex, Intuniv)

26
Q

This drug is about 65% efficacy for ADHD, takes about 6 weeks, may exacerbate tics, cause insomnia, and inhibits reuptake of NE/DA.

A

buproprion (wellbutrin)

27
Q

This drug is 70% efficacy for ADHD, has bad side effect profile, and must be titrate on and off use.

A

imipramine (TCA)

28
Q

This drug inhibits reuptake of SE/NE, and may cause increase in blood pressure.

A

Venlafaxine (effexor)

29
Q

This is a chronic familial disorder having motor tics and one vocalization tic.

A

Tourette’s disorder

30
Q

How long much tics have occurred for a diagnosis? more common in males or females?

A

1 year, common in males

31
Q

What drugs are used for Tourette’s disorder and what is their potential to cause EPS?

A

Haloperidol, Pimozide = risk EPS, symptoms regress in 48-72hours
Clonidine = no risk for EPS, 50% effective

32
Q

This is the repeated involuntary or unintentional voiding of urine by day or night.

A

Enuresis

33
Q

What are diagnostic criteria for enuresis?

A

2 episodes per week for 3 months
child is at least 5 years old
impairment of social function
distress

34
Q

How is enuresis treated non-pharmacologic?

A

Education

Behavior/ condition methods may take 3-4 months but are 70% effective

35
Q

What drug for enuresis is 70-85% effective, and is dosed 25mg qhs increasing 25mg per week if needed.

A

Imipramine

36
Q

What drug is a synthetic analog of ADH, is 70% effective in enuresis?

A

Desmopressin acetate

37
Q

What counseling point should be told about desmopressin acetate?

A

Evening fluids should be limited to 8 ounces to prevent hyponatremia or water intoxication

Pharmacotherapeutics (12 decks)

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