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25 Cards in this Set
- Front
- Back
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What dz is the MC neurobehavorial disorder of childhood, the most extensively studied, and the most chronic condition of school age children.
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ADHD
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What is a CHRONIC, FAMILIAL disorder with
1. Attention Deficit 2. Motor Hyperactivity 3. Impulsivity/decreased self-inhibitory |
ADHD
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What are the 3 subclasses on ADHD based on DSM-IV?
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1. ADHD: predominately inattentive type (often referred clinically simply as ADD)
2. ADHD: predominately hyperactive/impulsive type (rare) 3. ADHD: combined type (most common) |
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In addition, what are two characteristics to make diagnosis of ADHD (age and place)?
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1. before age 7
2. Must occur in 2 setttings. |
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Are the previous characteristics met easily?
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There are currently some challenges to these criteria, aimed at separating out the essence of ADHD as a neurobiological condition from its triggers (environment), impairments in functioning (carrying out activities, participation in life situations), so as to be able to evaluate the effects of interventions and measure outcomes.
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What is the MoA of drugs used to treat ADHD?
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--increase catecholamine levels
--increase in NE/D2 --Amoxatine is a SNRI (increase NE) |
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LYING specifically to cover up inattention/forgetfulness (e.g. Parent: “What do you have for homework?” Child: “I don’t have any.” or “I finished it in school.”)
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symptoms of Inattention/distractibility of ADHD
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Which type of ADHD:
Child may be described as a “dreamer”, or “always off in her/his own world”. |
Inattentive ADHD
Child may recognize his/her own inability to concentrate, but be brushed off as “just making excuses”. |
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Which subclass of ADHD is often recognized later than the others?
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Inattentive ADHD
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This subclass of ADHD presents with a child in constant motion, talk nonstop, jumping from subjects, fidgety, UNDERWEIGHT.
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Hyperactivity ADHD
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70% of ADHD patients also have...
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Co-morbid conditions (sleep, anxiety, mood, disruptive)
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What other comorbidity is strongly linked with ADHD?
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Bipolar Disease
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How do you diagnose ADHD?
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1. Screening (Conner's scale)
2. Personal and Family Hx 3. Psychoeducational evaulation |
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What are the two goals of treatment?
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1. Decrease symptoms
2. Improve quality of life |
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Pharmacologic treatment of ADHD?
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1. Stimulant drugs (methylphenidate, dextroamphetamine) have long been the standard of treatment.
2. Other noradrenergic (atomoxetine) and dopaminergic (bupropion) drugs are used 3. CBT? |
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Which is the more effective treatment? Pharmacologic or CBT for ADHD?
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Pharmacologic.
general, studies indicate a 75-95% response to a first prescribed stimulant medication, with 10-20% of non-responders showing improvement with the other. [Sister-brother |
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What are Methylphenidate and Dextroamphetamine?
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DOC for ADHD.
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What should children on Adderall be screened?
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Cardiac Health.
An EKG be done ONLY when + history or PE signs are present. |
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What are some common AR's of Adderrall?
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1. Insomnia/or reverse
2. Decreased appetite 3. CV 4. Tics |
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Addiction and ADHD?
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1. Increased addiciton potential in ADHD
2. Risk of substance abuse with stimulants increases by 50% 3. |
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What are adderrall's effects on intelligence?
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-Medication significant increases in IQ scores
-Medication significant positive effects on neuropsychological testing in reaction times and errors of omission and commission -Medication did not improve knowledge application in longitudinal studies |
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What is an alternative drug to treat ADHD?
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1. Atomoxetine
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How should you approach treatment for a child with ADHD?
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When improvement occurs, be sure to give the child credit for making “good choices”!!!
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What is the outlook of a child with ADHD into adulthood?
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--80% of children with ADHD will become adults with ADHD.
--Some (especially inattentive type) will accommodate well (through learning coping and interpersonal skills, making good career choices, and finding understanding friends and life partners |
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Prognosis of UNTREATED child with ADHD?
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Some, if untreated, will not be able to hold jobs or have lasting friendships or marriages; will be involved in (and cause) more than a normal number of accidents; will become depressed, self-medicate with caffeine, develop problems with drug abuse, depression, etc.
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