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Spring 2024 Therapeutics 3 > Exam 4 Pediatric Psychiatry > Flashcards

Exam 4 Pediatric Psychiatry Flashcards

1
Q

Why is medication use limited in children?

A

Kids have a higher risk of significant adverse effects from medications than adults

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2
Q

What are the two psychiatric medications approved for kids and at what ages can they be used?

A

Risperidone: Age 5

Aripiprazole: Age 6-17

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3
Q

What criteria need to be met to be diagnosed with Tourette’s Disorder?

A

Tics can wax and wane in frequency but must be present for > 1 year

Onset before age 18

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4
Q

What comorbidities are common with Tic Disorders?

A

ADHD -75%

OCD -50%

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5
Q

What is the Rule of Thirds for tic disorders?

A

1/3 resolve
1/3 improve
1/3 stay the same

(about 10% have persistent symptoms as adults)

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6
Q

True or False: Stimulants can cause tics

A

TRUE
-we still treat ADHD though
-even if they exacerbate the tics, if benefit is greater then keep them on the stimulant

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7
Q

What is the first-line treatment for tic disorders?

A

Alpha-2 Agonists

-Clonidine
-Guanfacine
*ER Guanfacine

(30% reduction)

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8
Q

What is the second-line treatment for tic disorders?

A

Atypical antipsychotics

***Aripiprazole
Risperidone

(30-60% reduction)

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9
Q

What is the third-line treatment for tic disorders?

A

Typical antipsychotics

Haloperidol
Pimozide

(80% reduction)

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10
Q

Which medication has weight-based dosing?

A

Aripiprazole

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11
Q

Which medication has the highest D2 block of all atypical antipsychotics?

A

Risperidone/Paliperidone

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12
Q

What are the age cut-offs for the two types of Conduct Disorder?

A

Childhood-Onset: <10 years old
Adolescent-Onset: >10 years old

Unspecified Onset: unclear information to determine age of onset

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13
Q

What is the most common comorbid condition with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)?

A

ADHD

**must treat underlying conditions

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14
Q

What are the fist-choice drugs for treating Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)?

A

Stimulants

Clonidine/Guanfacine

*atypical antipsychotics are second-choice
*often see combination

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15
Q

When would we treat Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) with atypical antipsychotics?

A

-Severe persistent aggression
-Serious oppositional behaviors
-Defiance

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16
Q

When would we use a combination stimulant/alpha antagonist for Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)?

A

If comorbid ADHD with impulsivity or need for sedation for sleep

17
Q

What is the first-line drug therapy for Separation Anxiety Disorder?

A

SSRIs (fluoxetine down to 8 years old)

*note that first-line treatment is therapy

18
Q

What are the associated medical disorders with Autism Spectrum Disorder?

A

-Seizure disorder (up to 30%)

-GI disorders

19
Q

What medications are used for Autism Spectrum Disorder?

A

No medications have currently shown efficacy in treating the core symptoms

For irritability/aggression or :stereotypy and hyperactivity:
-Aripiprazole (6-17yo)
-Risperidone (5-16yo)

*NOTE: lamotrigine/levetiracetam have no effect on irritability

20
Q

What are the drugs used for repetitive behaviors?

A

Antipsychotics: Haloperidol, Risperidone, Aripiorazole

21
Q

What medication can be used to help with sleep?

A

Melatonin 1-6mg nightly

22
Q

What is Disruptive Mood Dysregulation Disorder (DMDD)?

A

-Severe recurrent temper outbursts manifesting verbally that are out of proportion with the intensity/duration of the situation

*present in at least 2 out of 3 settings and severe in at least 1

*diagnosis not made before age 6 or after age 18

23
Q

What is the treatment used for Disruptive Mood Dysregulation Disorder (DMDD)?

A

SSRIs and Stimulants

*similar to depression, ADHD, or anxiety
*differentiate from bipolar disorder to decipher whether to use antidepressants and need for mood stabilizers

24
Q

What is the only anti-depressant FDA approved to treat kids down to 8 years old?

A

Fluoxetine

25
Q

What antidepressant is used to treat kids 12-17 yo?

A

Escitalopram

26
Q

Which antidepressant should be avoided in kids because of its suicidal thinking warning?

A

Paroxetine

27
Q

What is the overall preferred drug for bipolar treatment in kids?

A

Lithium
(all stages of bipolar disorder)

28
Q

What is the first-line treatment pediatric PTSD?

A

Trauma-focused psychotherapy

29
Q

What is the first-line drug therapy for pediatric PTSD?

A

SSRIs

30
Q

To be considered childhood-onset schizophrenia, by wat age must the disease onset occur?

A

Before age 13

31
Q

Adolescent prevalence of schizophrenia reaches what % adult prevalence?

A

0.5-1%

32
Q

Which antipsychotics are not used in pediatric patients?

A

-Iloperidone
-Cariprazine
-Lumateperone

Spring 2024 Therapeutics 3 (24 decks)

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