Exam 4 - Lec 64 ADHD Ott Flashcards
____ of children with ADHD will have the diagnosis in adulthood
a. 1/4
b. 1/3
c. 1/2
b. 1/3
which of the following is FALSE about ADHD?
a. higher rate if diagnosed in a first degree relative
b. etiology is multifactorial (environmental, genetics, physiological)
c. dec risk of substance use and antisocial personality disorder if ADHD left untreated
c. dec risk of substance use and antisocial personality disorder if ADHD left untreated
(it would be increased)
which of the following is FALSE about ADHD diagnostic criteria?
a. for each sx domain, must have at least 6 sx present
b. for ages 17 and up, at least 5 sx are required for either of the two specifiers
c. several inattentive or hyperactive sx must be present prior to age 10
d. sx are present in 2 or more settings
c. several inattentive or hyperactive sx must be present prior to age 10
(prior to age 12)
look at slide 8 and 9 for sx of inattention and hyperactivity
ok
T or F: for stimulant dosing, we calculate pediatric pts based on mg/kg
F (variations in dosing not found to be due to height or weight)
IR stimulants are preferred for pts weighing < ___ kg due to limited low-dose availability of LA stimulants
< 16 kg
T or F: for stimulant dosing, late afternoon sx may require longer-acting formulation
T
T or F: pts can take an amphetamine-based and methylphenidate-based stimulant at the same time
F
Mydayis is indicated for pts age ___ and up
13
Mydayis dose for ages 13-17
a. 25 mg/day
b. 12.5 mg/day
b. 12.5 mg/day
what is the formulation for Daytrana?
patch
what medication is a prodrug that is converted to dextroamphetamine?
a. Mydayis
b. Daytrana
c. Vyvanse
d. Jornay PM
c. Vyvanse
when should a Jornay PM dose be taken?
in the evening between 6:30-9:30 pm (helps with morning problems)
which of the following are NOT considered common AE’s of stimulants?
a. stomach ache
b. insomnia
c. hallucinations
d. reduced appetite
e. risk for sudden cardiac death
f. jitteriness
c, e (these ones are uncommon)
if a pt experiences hallucinations from a stimulant, how should we manage it?
a. reduce dose
b. d/c stimulant and reassess diagnosis
c. divide dose, give with food
d. switch formulation
b. d/c stimulant and reassess diagnosis
two alpha 2 agonists for ADHD
guanfacine ER
clonidine ER
guanfacine ER is a substrate of which CYP?
a. 1A2
b. 2D6
c. 3A4
c. 3A4
alpha 2 agonists must be tapered if d/c to avoid _____ _____
rebound hypertension
two NE reuptake inhibitor drugs
atomoxetine
viloxazine
which of the following is FALSE about atomoxetine?
a. it is an NE reuptake inhibitor
b. 2D6 substrate
c. weight-based dosing
d. none of the above
d. none of the above
which of the following is FALSE about viloxazine?
a. 2D6/UGT substrate
b. strong 1A2 inhibitor
c. weight-based dosing
d. capsules can be swallowed whole or put in applesauce
c. weight-based dosing
which drug class causes inc HR and BP, and has a boxed warning for increase in suicidal thinking?
a. NE reuptake inhibitor
b. alpha 2 agonists
a. NE reuptake inhibitor
which drug class has the following AE?
-dec HR and BP, orthostasis
-somnolence
-dizziness
-rebound HTN if abrupt d/c
a. NE reuptake inhibitor
b. alpha 2 agonists
b. alpha 2 agonists
LFTs and growth rate should be monitored for which non-stim medication?
a. clonidine
b. guanfacine
c. atomoxetine
d. viloxazine
c. atomoxetine
T or F: bupropion is FDA-approved for ADHD
F
bupropion CI (2 of them)
seizure disorders and eating disorders
bupropion is a ____ inhibitor
a. 1A2
b. 2D6
c. 3A4
b. 2D6
T or F: TCAs are more effective than methylphenidate
F
TCAs have ______ concerns - sudden ______ death in children, lethal in overdose (same word in each blank)
cardiac
mood stabilizers and atypical antipsychotics may be useful if a pt with ADHD also has one of what 3 conditions?
bipolar disorder
conduct disorder
intermittent explosive disorder
T or F: atypical antipsychotics can be used as monotherapy for ADHD
F
AAP first line medication recommendation for preschool age pts
methylphenidate
AAP first and second line tx for elementary/middle school/adolescents pts
first line: stimulants
second line: atomoxetine, guanfacine or clonidine ER
according to AAP, what two drugs can be used as adjuncts to stimulants?
clonidine ER and guanfacine ER
look at the NICE: ADHD Guidelines 2018 for adults (slide 31)
fo sho
