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30 Cards in this Set
- Front
- Back
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Define ADHD diagnosis:
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--> 6 symptoms of inattention or hyperactivity-impulsivity
--present for > 6 months --symptoms present prior to age 7 --impairment in > 2 settings |
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List symptoms of inattention:
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inattentive to details or activities
difficulty sustaining attention does not appear to listen when spoken to lack of follow through difficulty with organization avoidance or dislike of tasks requiring mental effort frequently losing things easily distracted by external stimuli forgetfulness |
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List symptoms of hyperactivity-impulsivity
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frequent fidgeting and squirming
inappropriately leaves seat in class inappropriately runs or climbs excessively difficulty playing or performing activities quietly often "on the go" or "driven by a motor" often talks excessively blurts out answers prematurely difficulty awaiting turn often interrupts or intrudes on others |
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What is the most common type of ADHD?
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combined type
(inattentive type, hyperactive-impulsive type) |
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Is ADHD more common in males or females?
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males
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Explain the pathophysiology of ADHD:
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decreased DA, decreased NE, increased MAO
-or- decreased blood flow to frontal lobe |
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What are the treatment options for ADHD?
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CNS stimulants
NE reuptake inhibitors ADs alpha-2-adrenergic agonists |
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B/G: methylphenidate
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Ritalin, Methylin, Concerta, Metadate, Focalin, Daytrana (patch)
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B/G: dextroampthamine
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Dexedrine
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B/G: Dextroamphetamine/Amphetamine
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Adderall, Adderall XR, generic (salts)
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B/G: Lisdexamphetamine
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Vyvanse
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How do stimulants work for treatment of ADHD?
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increase NE and DA (agonists and reuptake blockade)
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What symptoms of ADHD will stimulants not improve?
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academic performance
learning problems social skills oppositional behavior emotional problems long-term cognitive, academic, behavioral and social problems |
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Describe the effect of stimulant treatment for ADHD:
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"lightening" quick response rate
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List adverse effects common with stimulants:
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(generally mild)
loss of appetite weight loss insomnia anxiety, irritability headache tics growth retardation |
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What is an important thing to screen for before initiating stimulant therapy?
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CV risk
--complete physical --ECG --complete family history of CV disease |
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What can be done to manage loss of appetite with stimulants?
insomnia? |
give dose after meals
give dose after 4 PM |
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How does atomoxetine work?
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(Strattera)
NE reuptake inhibitor less abuse potential 2D6 substrate |
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What drugs can be used for ADHD other than stimulants and atomoxetine?
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Bupropion, TCAs
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What are some side effects of TCAs?
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--risk of adverse CV events
--anticholinergic SEs --weight gain --sedation |
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What are some examples of alpha-2-adrenergic agonists?
What side effects are unique to these drugs? |
clonidine (Catapres)
Guanfacine (Tenex); used more commonly b/c of better dosing regimen --hypotension, dizziness |
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Define tics:
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rapid and repetitive muscle contractions resulting in involuntary movements or vocalizations
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How are tics classified?
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motor vs. vocal
simple vs. complex simple-motor--eye blinking, neck jerking, shoulder shrugging, facial grimacing complex-motor--grooming behaviors, smelling of objects, jumping, touching behaviors simple-vocal--coughing, throat clearing, grunting, sniffing, snorting, barking complex-vocal--repeating words or phrases out of context |
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echopraxia
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repeating gestures
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copropraxia
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inappropriate gestures
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coprolalia
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saying inappropriate things
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palilalia
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repeating own words
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Define Tourette's:
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--multiple motor tics and one or more vocal tics
--occur throughout the day |
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Is Tourette's more common in males or females?
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males (3:1)
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List common pharmacotherapies for tics:
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conventional and atypical APs
alpha-2-adrenergic agonists |
