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Clin Therapeutics II (Spring 2018) > Exam 4: ADHD > Flashcards

Exam 4: ADHD Flashcards

1
Q

Which type ADHD: ≥6 symptoms for >6 months. Different than others at that development stage and associated with negative consequences?

A

Inattention

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2
Q

Which type ADHD: ≥6 symptoms for >6 months. Inconsistent with developmental level and negatively impairs social and academic/occupational activities

A

Hyperactivity and Impulsivity

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3
Q

What age must several ADHD symptoms be present?

A

12

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4
Q

Impairment from symptoms in at least how many settings?

A

Two

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5
Q

Clear evidence of what?

A

Interference or quality reduction of developmentally appropriate social, academic, or occupational functining

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6
Q

Disturbances not occur when what else?

A

Other mental disorders

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7
Q

ADHD etiology?

A

Genetic. Multiple DA and NE genes involved.

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8
Q

ADHD-like behavior when what was blocked?

A

NE alpha 2 receptor

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9
Q

Who is required to make ADHD dx? (hint: 3)

A
  1. Parent
  2. Teacher
  3. Physician (ummm…does he know he is lecturing to PA students?)
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10
Q

1 tx for ADHD?

A

Stimulants

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11
Q

2 types of stimulants for ADHD tx?

A
  1. Amphetamines

2. Methylphenidate

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12
Q

Methylphenidate MOA?

A

Block DA and NE reuptake

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13
Q

Methylphenidate begins working when?

A

within first day of dosing

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14
Q

2 big ADRs of Methylphenidate?

A
  1. Insomnia

2. Decreased appetite

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15
Q

Methylphenidate patch has more or less ADRs than PO?

A

More

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16
Q

Amphetamine MOA?

A

Blocks DA and NE reuptake and enhances release in synapse. Also inhibits MAO and directly stimulated alpha and beta receptors.

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17
Q

Amphetamine preferred dosing?

A

Every day

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18
Q

Which Amphetamine has lease abuse risk?

A

Lis-dexamphetamine

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19
Q

Amphetamine DDI with which 2 SSRIs?

A
  1. Paxil

2. Prozac

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20
Q

SSRI and Methylphenidate ok together?

A

Yup

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21
Q

Do stimulants increase seizure risk?

A

Nope

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22
Q

Amphetamine and growth?

A

2cm effect on growth

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23
Q

How to manage Amphetamine-caused growth issues?

A

Weekend vacation or summer vacation if parents can stand it

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24
Q

Who most frequently misuses Amphetamines?

A

College students

25
Q

Which Amphetamine is safer- short acting or long acting?

A

Long acting

26
Q

Atomoxetine MOA?

A

Block NE reuptake. Small amount of DA increase.

27
Q

Atomoxetine onset?

A

Days

28
Q

Atomoxetine max improvement?

A

Up to 6 weeks

29
Q

Atomoxetine DDI with which SSRI?

A

Paroxetine. Increases Atomoxetine by 600%!!!

30
Q

When to dose Atomoxetine?

A

Morning. Sometimes in afternoon.

31
Q

Atomoxetine better if what 2 cormorbid problems?

A
  1. Anxiety

2. Substance use problem

32
Q

First-line tx for adults with ADHD?

A

Atomoxetine

33
Q

Which is better- Atomoxetine or stimulants?

A

Stimulants are slightly better

34
Q

Guanfacine MOA? (hint: it’s a lot of words)

A

Alpha 2 agonist stimulates alpha-2a post synaptic receptors in prefonral areas causing strenthened connection in attention areas

35
Q

Which is better for ADHD- Guanfacine or stimulants?

A

Stimulants

36
Q

Stimulants and Guanfacine?

A

Use Guanfacine as adjunct therapy with stimulants

37
Q

Guanfacine dosed at night helps with what?

A

Sleep

38
Q

Guanfacine dosed in morning helps with what?

A

ADHD

39
Q

Is Guanfacine effective for inattention ADHD?

A

Nope! Stimulants way better.

40
Q

Which 2 disorders is Guanfacine really good for?

A
  1. Oppositional defiant disorder

2. Conduct disorder

41
Q

Guanfacine full effect in how long?

A

4 weeks

42
Q

Guanfacine and CV?

A

Decreased BP and HR

43
Q

Guanfacine and somnolence?

A

Causes somnolence and sedation

44
Q

Guanfacine ok for tics?

A

Yup

45
Q

Clonidine compared to Guanfacine

A

Clonidine is less specific than guanfacine. More sedation and greater decrease in BP.

46
Q

Clonidine’s half-life compared to Guanfacine?

A

Shorter, causing more frequent dosing.

47
Q

Clonidine + Stimulant good for what?

A

CV problems

48
Q

Amphetamine and tics?

A

High dose amphetamine makes tics worse

49
Q

Atomoxetine and tics?

A

Doesn’t worsen tics but not as good for ADHD as methylphenidate

50
Q

First med to use for ADHD with tics?

A

Methylphenidate

51
Q

Alpha-2-agonist and tics?

A

Will reduce tics but not as good for ADHD as Methylphenidate

52
Q

Adult ADHD and intensity of sx?

A

Reduced compared to kids

53
Q

Is Adult ADHD easy to dx?

A

Hard!

54
Q

What to treat first in Adult ADHD?

A

All othe problems first (like pain, anxiety, depression, etc)

55
Q

Which tx to apply first for Adult ADHD?

A

Non-pharm interventions like Omega-3-fatty acids

56
Q

Short or long acting stimulants preferred in ADHD?

A

Long-acting

57
Q

If stimulants ineffective then use what? (2 options)

A
  1. Atomoxetine

2. Alpha-2-agonist

58
Q

Which med is preferred adjunct to stimulants?

A

Alpha-2-agonist

Clin Therapeutics II (Spring 2018) (11 decks)

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