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Therapeutics III > Exam 4 - Ott ADHD and PEDs > Flashcards

Exam 4 - Ott ADHD and PEDs Flashcards

1
Q

When used in ASD, aripiprazole is 1/2 first line agents in ages _____ and used for _____

A

6-17 & irritability/aggression

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2
Q

When used in ASD, risperidone is 1/2 first line agents in ages _____ and used for _____

A

5-16 & irritability/aggression

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3
Q

what antidepressant is FDA approved to treat kids with depression down to 8 years old?

A

fluoxetine

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4
Q

what antidepressant is FDA approved to treat kids with depression 12-17 years old?

A

escitalopram

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5
Q

tx of depression in children step therapy

A
  1. non-pharm: family/caregiver support (necessary for success)
  2. cognitive behavioral therapy
  3. antidepressant medications
    3.a. fluoxetine, escitalopram, sertraline
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6
Q

Peds PTSD tx step therapy

A
  1. Trauma-focused psychotherapy is 1st line tx
  2. SSRIs are 1st line drugs
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7
Q

aripiprazole - brand name

A

Abilify

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8
Q

asenapine - brand name

A

Saphris

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9
Q

brexpiprazole - brand name

A

Rexulti

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10
Q

lurasidone - brand name

A

Latuda

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11
Q

olanzapine - brand name

A

Zyprexa

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12
Q

olanzapine/fluoxetine - brand name

A

Symbyax

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13
Q

paliperidone - brand name

A

Invega

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14
Q

quetiapine - brand name

A

Seroquel

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15
Q

risperidone - brand name

A

Risperdal

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16
Q

(1) paliperidone - Diagnosis and age range

A

Schizophrenia - 12+

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17
Q

guanfacine ER - Brand name and CYP substrate

A

Intuniv (alpha-2-agonist)
-remember: 3A4 substrate

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18
Q

clonidine ER - Brand name

A

Kapvay (alpha-2-agonist)

19
Q

what 2 drugs must you taper to avoid rebound HTN in peds ADHD

A

gaunfacine ER
clonidine ER

20
Q

atomoxetine - Brand name

A

Strattera (norepi. reuptake inhibitor)

21
Q

viloxazine - brand name

A

Qelbree (norepi. reuptake inhibitor)

22
Q

atomoxetine - considerations

A

2D6 substrate
weightbased dosing

23
Q

viloxazine - considerations

A

2D6/UGT substrate, 1A2 inhibitor
capsules, swallow whole or put in applesauce

24
Q

norepi. reuptake inhibitor AE

A

increased HR and BP
boxed warning for increased suicidal thinking

25
Q

alpha-2-agonist AE

A

decreased HR and BP
somnolence
dizziness
rebound HTN if abrupt DC

26
Q

Bupropion - considerations

A

NOT FDA approved for ADHD but still used after other therapies tried if necessary
2D6 inhibitor
CI in seizure disorders and eating disorders

27
Q

Tricyclic antidepressants - considerations

A

less effective than methylphenidate
sudden cardiac death may occur in children

28
Q

atypical antipsychotics in ADHD

A

may be useful if there is a comorbid bipolar disorder, conduct disorder
should not be used as monotherapy

29
Q

ADHD drug therapy considerations by age - preschool

A

1st line: methylphenidate

30
Q

ADHD drug therapy considerations by age - elementary/middle school

A

1st line: stimulants
2nd line: atomoxetine, gaunfacine ER, Clonidine ER

31
Q

_____% of children with ADHD will have diagnosis in adulthood

32
Q

(increased/decreased) risk of substance use and antisocial personality disorder if ADHD is left untreated

33
Q

diagnostic criteria for ADHD (there are 4)

A
  1. for each Sx domain, must have at least 6 symptoms present
  2. for pts 18+, at least 5 Sx are required for either of the two specifiers
  3. several inattentive or hyperactive Sx must be present prior to age 12
  4. Sx present in 2 or more settings
34
Q

stimulant dosing considerations (4)

A
  1. calculating weight based dosing not helpful
  2. IR preferred in pts weighing less than 16kg
  3. don’t use two different stimulants but can use 2 forms of one drug (long acting and short acting for example)
  4. late afternoon Sx may require long-acting formulation
35
Q

Mydayis (mixed amphetamine salts) used in ages _____

36
Q

Daytrana (methylphenidate) utilizes _____ dosage form

37
Q

Vyvanse (lisdexamphetamine) a _____ and converted to ______ via hepatic first pass metabolism

A

prodrug, dextroamphetamine

38
Q

Jornay PM (methylphenidate HCl) should be taken what time of day?

A

take dose in evening between 6:30-9:30pm

39
Q

Stimulant AE (11)

A

appetite loss (weight loss)
ab pain
HA
sleep distubrances
decreased growth
hallucinations or other psych Sx
Increased BP
Increased HR
sudden cardiac death
priapism
peripheral vasculopathy (Raynaud’s)

40
Q

how to manage hallucination Sx caused by stimulant

A

DC stimulant, reassess diagnosis

41
Q

how to manage risk for sudden cardiac death Sx caused by stimulant

A

assess risk of cardiac structural abnormality and family history
-if concern is present, cardiac ECHO can be done

42
Q

age range for atypical antipsychotics in PEDS - schizophrenia

43
Q

age range for atypical antipsychotics in PEDS - Bipolar Disorder

Therapeutics III (22 decks)

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