Week 7
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Questions and Answers

What is the drug of choice for adults with ADHD?

  • Clonidine
  • Amphetamine (Adzenys)
  • Bupropion (Wellbutrin) (correct)
  • Atomoxetine (Strattera)

    • What might adults who struggle with executive functioning & disorganization difficulties also experience?

  • Decreased cognition
  • Improved cognitive impulsivity
  • Enhanced self-regulation
  • Heightened anxiety & occupational stress (correct)

    • Which ADHD medication should be avoided in the elderly?

  • Clonidine & guanfacine
  • Atomoxetine (Strattera)
  • bupropion (Wellbutrin)
  • Lisdexamfetamine (Vyvanase) (correct)

    • Which symptom of ADHD decreases markedly with age?

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

    What medication should be prescribed for individuals with a history of substance abuse?

    <p>Atomoxetine (Strattera)</p> Signup and view all the answers

    Which neurotransmitters play a role in the symptoms and treatment of ADHD?

    <p>Norepinephrine &amp; Dopamine</p> Signup and view all the answers

    Which type of medication is recommended for children with ADHD?

    <p>Stimulants like amphetamine (adzenys)</p> Signup and view all the answers

    When do ADHD symptoms typically become noticeable due to abnormalities in the circuits in the PFC or errors in the synaptic pruning process according to the text?

    <p>6-7 years old</p> Signup and view all the answers

    Which neurotransmitters are associated with inefficient information processing in the prefrontal circuits?

    <p>Norepinephrine (NE) and Dopamine (DA)</p> Signup and view all the answers

    What is the youngest age at which ADHD can appear based on the text?

    <p>3 years old</p> Signup and view all the answers

    Which brain loop regulates both anxiety and ADHD according to the text?

    <p>Corticostriatal thalamocortical (CSTC) loop</p> Signup and view all the answers

    What is required before prescribing stimulant medications based on the text?

    <p>A comprehensive health history</p> Signup and view all the answers

    All of the following are symptoms of impulsivity ( Excessive talking, blurting things out, not waiting one's turn, interrupting) are modulated by what area of the brain?

    <p>orbitofrontal cortex</p> Signup and view all the answers

    What is a common side effect of stimulant medications that can either cause or worsen symptoms of tics?

    <p>Reduced appetite</p> Signup and view all the answers

    Which part of the brain is responsible for modulating hyperactivity symptoms?

    <p>Prefrontal cortex</p> Signup and view all the answers

    In what way do hyperactive symptoms typically change as children age?

    <p>They decline markedly, become more subjective &amp; less obvious/apparent to others</p> Signup and view all the answers

    Which factor plays an important role in the development of ADHD according to the text?

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

    What is the higher risk for diversion, short-acting or long-acting stimulant medications?

    <p>Short-acting medications</p> Signup and view all the answers

    What is the correct protocol for switching patients from one stimulant medication to another?

    <p>Discontinue the current medication and start the new one at a starting dose the next day</p> Signup and view all the answers

    What are the two forms in which stimulant medications are available?

    <p>Sustained-release and immediate-release</p> Signup and view all the answers

    How should stimulant medications be monitored?

    <p>Regularly monitor for efficacy and side effects</p> Signup and view all the answers

    All of the following are common side effects of stimulants EXCEPT

    <p>Dizziness, blurred vision, fatigue, muscle weakness</p> Signup and view all the answers

    When are clients more likely to experience a 'crash' with stimulant medications?

    <p>After taking immediate-release medications</p> Signup and view all the answers

    What is the recommended time to take stimulant medications to decrease anorexia?

    <p>With breakfast</p> Signup and view all the answers

    Which neurotransmitters are associated with inefficient information processing in prefrontal circuits?

    <p>Norepinephrine and dopamine</p> Signup and view all the answers

    Why should occasional urine drug screens be obtained for clients on stimulant medications?

    <p>To confirm the presence of amphetamines &amp; other substances of abuse</p> Signup and view all the answers

    Which symptom is NOT commonly associated with stimulant use?

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

    What may clients experience when the stimulant medication wears off?

    <p>A 'crash' or worsening of symptoms</p> Signup and view all the answers

    What could be a possible effect of stimulant medications on weight?

    <p>Weight loss due to decreased appetite</p> Signup and view all the answers

    What is the main difference between NE and DA concerning inefficient information processing in prefrontal circuits?

    <p>Different neurotransmitter receptors activated</p> Signup and view all the answers

    Which type of medication is recommended for adults with ADHD?

    <p>A2 agonists (clonidine, guafacine) or NEDA (bupropoin-Wellbutrin)</p> Signup and view all the answers

    All of the following are _____________-symptoms of ADHD: inattention, restlessness, cognitive & emotional impulsivity, executive functioning defictis, & self regulation.

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

    What scheduled drug level are stimulant medications?

    <p>Schedule II</p> Signup and view all the answers

    Which of the following is NOT selective attention?

    <p>poor problem solving, difficulty completing tasks</p> Signup and view all the answers

    Which of the 4 categories is not considered symptoms of ADHD?

    <p>Mood swings</p> Signup and view all the answers

    Are refills permitted for stimulant medications?

    <p>No, no refills are permitted</p> Signup and view all the answers

    What diagnostic test must be obtained prior to prescribing stimulants?

    <p>ECG (electrocardiogram)</p> Signup and view all the answers

    What is the first step in managing symptoms of ADHD?

    <p>Obtaining a thorough health history</p> Signup and view all the answers

    Which of the 4 below should NOT be prescribed to those with a history of substance abuse?

    <p>dexmethylphenidate such as focalin</p> Signup and view all the answers

    Which of the following is NOT a symptom of hyperactivity?

    <p>Trouble speaking quietly</p> Signup and view all the answers

    Which medication, in combination with a stimulant, can increase anxiety?

    <p>Selective serotonin reuptake inhibitors (SSRIs)</p> Signup and view all the answers

    What can cause or worsen symptoms of tics in individuals with ADHD?

    <p>Stimulant medications</p> Signup and view all the answers

    What is the recommended time to take stimulant medications to decrease anorexia?

    <p>In the morning</p> Signup and view all the answers

    ADHD treatment efficacy will be seen within in what time frame?

    <p>1 week</p> Signup and view all the answers

    Which factor plays an important role in the development of ADHD?

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

    What should the NP assess before treating a patient for ADHD?

    <p>Bipolar disorder</p> Signup and view all the answers

    What diagnostic test must be obtained prior to prescribing stimulants for individuals with a history of cardiac disease?

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

    Which brain area is responsible for modulating hyperactivity symptoms?

    <p>Prefrontal Cortex</p> Signup and view all the answers

    What is the main difference between norepinephrine and dopamine concerning inefficient information processing in prefrontal circuits?

    <p>Norepinephrine is more involved in arousal</p> Signup and view all the answers

    Which symptom is typically NOT reported by adults?

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

    What is the age at which ADHD medications are contraindicated?

    <p>6 years and younger</p> Signup and view all the answers

    What is the effect of abrupt withdrawal of stimulants after prolonged use?

    <p>Irritability and rebound symptoms</p> Signup and view all the answers

    What is the recommended way to take stimulant medications to decrease anorexia?

    <p>Take with breakfast</p> Signup and view all the answers

    Which neurotransmitters are associated with inefficient information processing in prefrontal circuits d/t it being "out of tune"?

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

    What can cause appetite changes and subsequent weight loss in clients with ADHD?

    <p>Stimulant medications</p> Signup and view all the answers

    How soon would you expect treatment efficacy for ADHD to be seen?

    <p>within the 1st treatment</p> Signup and view all the answers

    Which medications are more likely to cause low birth weight in pregnancy?

    <p>Stimulant medications</p> Signup and view all the answers

    What can clients experience when the stimulant medication wears off, especially with immediate-release medications?

    <p>A worsening of symptoms, or 'crash'</p> Signup and view all the answers

    What is the main function of the prefrontal cortex in relation to ADHD?

    <p>Executive function</p> Signup and view all the answers

    How is increased irritability & insomnia treated in ADHD?

    <p>With low dose non-stimulant</p> Signup and view all the answers

    Which brain loop is responsible for regulating both anxiety and ADHD?

    <p>CSTC loop</p> Signup and view all the answers

    Are non-stimulants or stimulants contraindicated in breastfeeding?

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

    What is the set of skills referred to as 'executive function'?

    <p>A set of skills that underlie the capacity to plan, meet goals, display self-control, follow multiple-step directions even when interrupted, &amp; stay focused despite distractions.</p> Signup and view all the answers

    What is the effect of an imbalance in NE and DA on the prefrontal cortex?

    <p>Inefficient information processing</p> Signup and view all the answers

    When the CSTC loop malfunctions what two types of attention are affected?

    <p>Selective and sustained</p> Signup and view all the answers

    Why should anxiety be considered as an alternative diagnosis when pt. presents with symptoms of ADHD?

    <p>Because they are regulated by the same loop (CSTC)</p> Signup and view all the answers

    All of the following are risk factor for ADHD EXCEPT?

    <p>Maternal stress after pregnancy</p> Signup and view all the answers

    What is the mechanism of action of non-stimulant medications in ADHD?

    <p>Selective inhibition of presynaptic NE reuptake &amp; enhancement of NE neurotransmission</p> Signup and view all the answers

    What is the benefit of non-stimulant medications in ADHD?

    <p>Lowering distractibility and improving attention, working memory, &amp; impulsivity</p> Signup and view all the answers

    When are non-stimulant medications commonly used in ADHD?

    <p>In cases where stimulants are contraindicated or they do not respond to stimulants</p> Signup and view all the answers

    What is the role of NE and DA in ADHD?

    <p>They play a role in the symptoms and management of many mental health diagnoses</p> Signup and view all the answers

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