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Neurology > Pediatric Psychopharmacotherapy > Flashcards

Pediatric Psychopharmacotherapy Flashcards

1
Q

What is the first line therapy for pediatric ADHD?

A

Methylphenidate
* Avoid IR productive - diversion risks

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2
Q

Concerta

A
  • Take in the morning
  • AUC stimulates TID dosing regimen
  • Tablets intact in stool
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3
Q

Transdermal MPH-Daytrana

A
  • ADHD
  • Apply 2 hours before expected effects
  • Mild skin reactions, bleaching, tics, anorexia, and insomnia
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4
Q

Quillivant ER

A
  • ADHD
  • Vigorously shake bottle for at least 10 seconds
  • May be taken with or without food
  • Drug errors by pharmaceutics in reconstitution
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5
Q

Azstarys

A
  • 70% Serdexmethylphenidate (prodrug for d-methylphenidate) and 30% of IR d-methylphenidate
  • Daily dosing in the morning with or without food
  • For ADHD
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6
Q

Transdermal Dextroamphetamine - Xelstrym

A
  • ADHD in patients >= 6 years old
  • Application site reactions
  • Apply 2 hours before effect needed
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7
Q

Lisdexamfetamine (Vvyanse)

A
  • May reduce the risk of diversion, abuse
  • Approved for binge-eating disorder and ADHD
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8
Q

What is the preferred medication for ADHD in toddlers?

A
  • Behavioral Therapy and Parent Training Preferred with medication ONLY after 8-12 weeks-moderate to severe disability
  • Methylphenidate if needed
    • can exacerbate mood liability so they could go quickly into extreme irritabiltiy in 2-6 year olds
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9
Q

What medication to give for side effects of stimulants?

A
  • Atomoxetine
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10
Q

What are some nonstimulant options for ADHD?

A
  • Atomoxetine
  • Viloxazine (Qelbree)
  • Clonidine
  • Guanfacine
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11
Q

What are some adverse effects of atomoxetine?

A
  • Emesis
  • Nausea
  • Dyspepsia
  • Increased risk of suicidal ideation in children
  • Urinary retention
  • Priapism
  • Sudden death, stroke, MI
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12
Q

Viloxazine (Qelbree)

A
  • ADHD
  • Norepinephrine reuptake inhibitor and serotonin mediator
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13
Q

What are some adverse effects of Viloxazine (Qelbree)?

A
  • Somnolence, fatigue, decreased appetite
  • Increases HR
  • Risk of suicidal thoughts and suicidal ideation
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14
Q

How has pediatric psychotropic changed?

A
  • Medication creep (expanded drug classes without research)
  • Poly pharmacy more common
  • Diagnosis and treatment in the very young
  • Increased drug use in autism and intellectual disability
  • Health disparities in evaluation
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Neurology (21 decks)

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