Peds Psych Flashcards
who has highest risk adverse effects from medications?
kids
Tourettes
tics for >1 year
onset before 18
prevalence of other disease states with tic disorder
ADHD 75 %
OCD 50%
rule of thirds tic disorders
1/3 resolve
1/3 improve
1/3 stay the same
what percent have tic symptoms as adults
10%
first line treatment of tics
alpha 2 agonists
clonidine
guanfacine
second line treatment of tics
atypical antipshchotics
aripiprazole
risperidone
third line treatment of tics
typical antipsychotics
haloperidol
pimozide
aripiprazole FDA approved ij what age and dosing
tics
6-17 years
weight based dosing
stimulant use in tourettes can do what
exacerbate vocal and motor tics
what if cant use stimulant in ADHD due to bad sx of tics
try atomoxetine or tricyclic antidepressant
conduct disorder age specifications
childhood <10 years
adolescent > 10 years
or unspecified
when to consider drug therapy for ODD/CD
adjunct after baseline sx determined
interventions failed
aggression to dangerous levels
first line drugs ODD/CD
stimulants / guanfacine / clonidine
when to use atypical antipsychotics in ODD/CD
severe persisten aggression, serious behaviors or defiance
pts with ADHD and ODD or CD we commonly see with what meds
stimulant and clonidine/guanfacine
separation anxiety mild
psycotherapy
separation anxiety moderate to severe treatment
SSRi - fluoxetine / escitalopram
autism spectrum disorder is defined as
-persistent deficits in social communication and social interaction across multiple contexts