CHILDREN AND ADOLESCENTS - CNS Flashcards
Neurodevelopmental disorders
multifaced conditions characterised by impairments in cognition, communication, behaviour and/or motor skills resulting from ‘abnormal’ brain development
emotional and behavioural disorders
characterised as either internalizing or externalizing ‘problems’ - tend to occur as a consequence of ‘stressful’ environments/situations
examples of neurodevelopmental disorders
- intellectual disability
- communication disorders
- ASD
- ADHD
examples of emotional and behavioural disorders
- depression
- anxiety disorders inc. OCD/phobias/tics
- eating disorders
- conduct disorders
- challenging behaviours
unlicensed medicines definition
a drug that does not have marketing authority in the UK
off label use of a drug
a licensed drug is being used for an unlicensed indication (different doses, form etc.)
what are antipsychotics used for (first and second generation)
typical (1st gen.) and atypical (2nd gen.) used for
- psychosis
- bipolar disorder
- ASD associated stereotypes
- compulsions
- aggression and self-injurious behaviour
what symptoms do antipsychotics address?
- delusions
- paranoia
- disordered thinking
- aggression/irritability
which antipsychotic is used in treatment-resistant schizophrenia
CLOZAPINE
difference between 1st and 2nd generation antipsychotics
- SGAs less likely to cause extrapyramidal side effects and other symptoms as a consequence of blocked dopamine receptors
- SGA more cardiac toxic, cause weight gain/hypoglycaemia leading to ‘metabolic syndrome’ - a chronic endocrine disorder
AP monitoring requirements
- weight/BMI: initially and every 3 months
- U and Es: baseline and yearly
- blood glucose and lipids: initially and every 3 months
- prolactin: if symptoms or hyperprolactinaemia present
- ECG: initially if pt a ‘cardiac-risk’
- LFTs: baseline and yearly
ADHD - ICD-10 classification meaning
hyperkinetic disorder
narrower restrictive term requiring more pervasive and impairing symptoms
ADHD pathophysiology
ADHD has a ‘defective inhibitory’ response, the ‘compromised’ pre-frontal cortex cannot filter incoming stimuli
drug treatment enhances noradrenaline and dopamine transmission
dexamfetamine moa on synaptic release
facilities release of dopamine from presynaptic cytoplasmic storage vesicles (increase in synapse) and blocks dopamine transporter protein (inhibits reuptake)
methylphenidate moa on synaptic release
acts primarily on the dopamine receptor and has little effect on synaptic release
