CNS - ADHD

Question 1

ADHD Treatment in child aged 5 or over

Answer 1

1st line: Methylphenidate

2nd line: Lisdexamphetamine
(Long name long side effects)

Question 2

As lisdexamphetamine had long side effects, what can be used instead?

Answer 2

Dexamphetamine

Question 3

Children who cannot tolerate methylphenidate or lisdexamphetamine should use…?

Answer 3

Atomoxetine or Guanfacine

Question 4

ADHD Adult treatment first line?

Answer 4

First line:
Methylphenidate or Lisdexamfetamine

If pt cannot tolerate long duration of action; Dexamfetamine

Question 5

ADHD Adult 2nd line treatment?

Answer 5

Atomoxetine

Question 6

Atomoxetine side effects?

Answer 6

QT PROLONGATION
HEPATOTOXIC
Suicidal Thoughts

Question 7

Mr preparations?

Answer 7

Used for convenience, adherence

ALWAYS BRAND ONLY (pharmokinetics)

Question 8

Methylphenidates side effects?

Answer 8

Works on Sympathetic pathways

• High BP
• Tachycardia
• Arrythmias

Question 9

Common other side effects for methylphenidate?

Answer 9

Behaviour/mood change
More alert
Decreased appetite - monitor child growth

Question 10

Methylphenidate monitoring?

Answer 10

• Pulse
• BP
• Appetite
• Weight
• Height
• Psychiatric symptoms

***Initiation, following dose adjustment then 6monthly

Question 11

Lisdexamfetamine and Dexamfetamine side effects?

Answer 11

2 Part processs

1) Wakeful, active, paranoia, hallucinations, hypertension

2) Exhaustion, convulsions, coma, hyperthermia

Question 12

Lisdexamfetamine and Dexamfetamine monitoring?

Answer 12

Pulse
BP
Weight
Height
Psychiatric symptoms
Appetite

*initiation, dose adjustment & 6monthly