ADHD Background

<p>Risky behavior</p> Signup and view all the answers

<p>Parent training in behavior management</p> Signup and view all the answers

<p>Dopamine and norepinephrine</p> Signup and view all the answers

<p>ADHD is more common in boys</p> Signup and view all the answers

<p>Inattention, hyperactivity, and impulsivity</p> Signup and view all the answers

<p>A combination of medication and behavioral therapy</p> Signup and view all the answers

<p>Methylphenidate</p> Signup and view all the answers

<p>Children 6 years old and above</p> Signup and view all the answers

<p>Less than 6 symptoms</p> Signup and view all the answers

<p>6 months</p> Signup and view all the answers

<p>Talks excessively</p> Signup and view all the answers

<p>Inattention, hyperactivity, and impulsivity</p> Signup and view all the answers

<p>Fish oils</p> Signup and view all the answers

<p>Stimulants</p> Signup and view all the answers

<p>Atomoxetine</p> Signup and view all the answers

<p>Children 6 years old and above</p> Signup and view all the answers

<p>Guanfacine ER</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>The primary presenting symptoms of ADHD are inattention, hyperactivity, and impulsivity.</p> Signup and view all the answers

<p>The primary focus of ADHD research is on the catecholamine system, specifically the dopamine pathways.</p> Signup and view all the answers

<p>The first-line treatment for preschool-aged children with ADHD is parent training in behavior management and/or behavioral classroom intervention.</p> Signup and view all the answers

<p>The diagnostic criteria for ADHD according to the DSM-5 include symptoms of inattention and/or hyperactivity and impulsivity. For children up to age 16, there must be at least 6 symptoms of inattention or hyperactivity and impulsivity. For ages 17 and older, there must be at least 5 symptoms. These symptoms must have been present for at least 6 months and are inappropriate for the individual's developmental level.</p> Signup and view all the answers

<p>The primary symptoms of inattention in ADHD include failing to pay attention, having trouble holding attention, not paying attention when someone is talking, not following through on instructions, failing to finish schoolwork, having difficulty organizing tasks, avoiding or disliking tasks that require mental effort, losing things, being easily distracted, and being forgetful.</p> Signup and view all the answers

<p>Stimulants are the first-line medications for ADHD. These medications are considered the initial treatment option for patients with ADHD, especially those who are 6 years old and above. Long-acting formulations of stimulants are preferred for children to maintain more steady symptom control.</p> Signup and view all the answers

<p>Fish oils have been shown to modestly improve cognitive function and behavior in children with ADHD. They are increasingly used for various psychiatric conditions. Another natural product, melatonin, is used to help with sleep onset in individuals taking stimulants.</p> Signup and view all the answers

<p>ADHD = Most common neurodevelopmental disorder in children Symptoms = Inattention, hyperactivity, impulsivity Primary treatment = Stimulant medications and behavioral therapy First-line treatment for pre-school aged children = Parent training in behavior management and/or behavioral classroom intervention</p> Signup and view all the answers

<p>Dopamine pathways = Defects in these can play a role in ADHD Catecholamine system = Primary focus of ADHD research Methylphenidate = Can be considered if moderate-severe symptoms persist despite behavioral interventions Untreated ADHD = Can lead to impaired academic standing, poor social skills and risky behavior</p> Signup and view all the answers

<p>Stimulant medications = They raise dopamine and norepinephrine levels Behavioral therapy = Used in combination with medication for ADHD treatment Parent training in behavior management = First-line treatment for pre-school aged children Methylphenidate = Can be considered if moderate-severe symptoms persist despite behavioral interventions</p> Signup and view all the answers

<p>Fails to finish schoolwork = Inattention Often fidgets or squirms = Hyperactivity &amp; Impulsivity Does not follow through on instructions = Inattention Talks excessively = Hyperactivity &amp; Impulsivity</p> Signup and view all the answers

<p>Atomoxetine (Strattera) = Non-stimulant Guanfacine ER (Intuniv) = Non-stimulant Melatonin = Natural product Stimulants = First-line medications</p> Signup and view all the answers

<p>Greater than or equal to 6 symptoms for children up to age 16 = Inattention Greater than or equal to 5 symptoms for ages 17 and older = Hyperactivity &amp; Impulsivity Symptoms must have been present for at least 6 months = Both Inattention and Hyperactivity &amp; Impulsivity Symptoms interfere with functioning and are not caused by another disorder = General criteria</p> Signup and view all the answers

<p>Behavioral interventions = Should be used with first-line medications when available Stimulants = First-line medications for ADHD Fish oils = Shown to modestly improve cognitive function and behavior in children with ADHD Atomoxetine (Strattera) = Can be used first line when prescribers are concerned about the possibility of abuse</p> Signup and view all the answers

<p>Capsule</p> Signup and view all the answers

<p>Warming the food</p> Signup and view all the answers

<p>Suspension</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>The long-acting formulations that can be used for young children (and others) who cannot swallow capsules or tablets are: capsule (some can be sprinkled on applesauce), chewable tablet, orally-disintegrating tablet, patch, and suspension.</p> Signup and view all the answers

<p>When putting capsule contents in food, use a small amount of food, do not chew the beads, do not warm the food, and take it right away.</p> Signup and view all the answers

<p>The capsule contents of Vyvanse can be mixed in water, orange juice or yogurt for administration.</p> Signup and view all the answers

<p>Adderall XR, Ritalin lA = Sprinkled on a small amount of applesauce Vyvanse = Mixed in water, orange juice, or yogurt Suspension = Taken as is Patch = Applied directly on skin</p> Signup and view all the answers

<p>Do not chew the beads = When putting capsule contents in food Use a small amount of food = When putting capsule contents in food Take it right away = After mixing capsule contents in food Do not warm the food = Before mixing capsule contents in food</p> Signup and view all the answers

<p>Capsule = Contents can be mixed with food or drink Chewable tablet = Can be chewed and swallowed Orally-disintegrating tablet = Disintegrates in the mouth without the need for water Patch = Applied directly to the skin</p> Signup and view all the answers

<p>Atomoxetine</p> Signup and view all the answers

<p>Clonidine ER</p> Signup and view all the answers

<p>Guanfacine ER</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>False</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>Methylphenidate, Lisdexamfetamine, Dextroamphetamine/Amphetamine</p> Signup and view all the answers

<p>Atomoxetine, Guanfacine ER</p> Signup and view all the answers

<p>Clonidine IR, Diphenhydramine</p> Signup and view all the answers

<p>Methylphenidate = First-line stimulants Atomoxetine (Strattera) = Second-line non-stimulants Guanfacine ER (Intuniv) = Add-on medications Melatonin = Help sleep at night</p> Signup and view all the answers

<p>Stimulants = Take in AM Non-stimulants = Take if risk of abuse Guanfacine ER (Intuniv) = Can be used alone or as add-on Diphenhydramine = Help sleep at night (OTC, 25-50 mg)</p> Signup and view all the answers

<p>Concerta, Daytrana, Ritalin = Methylphenidate Vyvanse = Lisdexamfetamine Strattera = Atomoxetine Adderall and Adderall XR = Dextroamphetamine/Amphetamine</p> Signup and view all the answers

<p>New-onset psychosis or mania</p> Signup and view all the answers

<p>Loss of appetite</p> Signup and view all the answers

<p>Serotonin syndrome</p> Signup and view all the answers

<p>Stimulants have a high potential for abuse and dependence.</p> Signup and view all the answers

<p>Tourette's syndrome</p> Signup and view all the answers

<p>Increased risk of sudden death</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>True</p> Signup and view all the answers

<p>Stimulant medications have a high potential for abuse and dependence.</p> Signup and view all the answers

<p>Do not use within 14 days of an MAO inhibitor.</p> Signup and view all the answers

<p>Increased levels of dopamine and norepinephrine can increase heart rate and blood pressure.</p> Signup and view all the answers

<p>Priapism and Raynaud's disease</p> Signup and view all the answers

<p>The risk of serotonin syndrome is increased</p> Signup and view all the answers

<p>Loss of appetite</p> Signup and view all the answers

<p>Dilated pupils, increased heart rate and blood pressure, sweating, tremor, anxiety = Abuse of stimulant medications Severe depression = Withdrawal from stimulant medications Abnormal behavior, psychotic episodes = Long-term abuse of stimulant medications Hypertensive crisis = Use of stimulants within 14 days of an MAO inhibitor</p> Signup and view all the answers

<p>Marked anxiety, tension, agitation = Most stimulants Comorbid heart failure, recent myocardial infarction, arrhythmias or moderate-severe hypertension = Some stimulants Use within 14 days of an MAO inhibitor = Risk of hypertensive crisis History of Tourette's syndrome or other tic disorders = Most stimulants</p> Signup and view all the answers

<p>Increased levels of dopamine and norepinephrine = Increase in heart rate and blood pressure Cardiac disease at baseline = Increased risk of sudden death with stimulant use Presence of cardiac abnormalities = Avoidance of stimulant use Risk of serious cardiovascular events = Children and adults with or without preexisting cardiac disease</p> Signup and view all the answers

<p>Vascular problems = May require dose reduction or discontinuation Psychosis or mania = Can be new-onset or an exacerbation of preexisting conditions Lowered seizure threshold = Increases risk for seizures Serotonin syndrome = Risk increased with use in combination with other serotonergic drugs</p> Signup and view all the answers

<p>Loss of appetite = Can contribute to a decrease in a child's growth trajectory Visual disturbances = Includes difficulty with accommodation and blurry vision Serotonin syndrome = Risk increased when used with other serotonergic drugs Vascular problems = May require dose reduction or discontinuation</p> Signup and view all the answers

<p>Preexisting psychiatric condition = Caution should be used when prescribing stimulants Seizure threshold = Some stimulants can lower this, increasing the risk for seizures Child's growth trajectory = A loss of appetite, a common side effect, can contribute to a decrease in this Serotonergic drugs = Risk of serotonin syndrome is increased when stimulants are used in combination with these</p> Signup and view all the answers