71 Questions
What is the drug of choice for adults with ADHD?
Bupropion (Wellbutrin)
What might adults who struggle with executive functioning & disorganization difficulties also experience?
Heightened anxiety & occupational stress
Which ADHD medication should be avoided in the elderly?
Lisdexamfetamine (Vyvanase)
Which symptom of ADHD decreases markedly with age?
Hyperactivity
What medication should be prescribed for individuals with a history of substance abuse?
Atomoxetine (Strattera)
Which neurotransmitters play a role in the symptoms and treatment of ADHD?
Norepinephrine & Dopamine
Which type of medication is recommended for children with ADHD?
Stimulants like amphetamine (adzenys)
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?
6-7 years old
Which neurotransmitters are associated with inefficient information processing in the prefrontal circuits?
Norepinephrine (NE) and Dopamine (DA)
What is the youngest age at which ADHD can appear based on the text?
3 years old
Which brain loop regulates both anxiety and ADHD according to the text?
Corticostriatal thalamocortical (CSTC) loop
What is required before prescribing stimulant medications based on the text?
A comprehensive health history
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?
orbitofrontal cortex
What is a common side effect of stimulant medications that can either cause or worsen symptoms of tics?
Reduced appetite
Which part of the brain is responsible for modulating hyperactivity symptoms?
Prefrontal cortex
In what way do hyperactive symptoms typically change as children age?
They decline markedly, become more subjective & less obvious/apparent to others
Which factor plays an important role in the development of ADHD according to the text?
Genetics
What is the higher risk for diversion, short-acting or long-acting stimulant medications?
Short-acting medications
What is the correct protocol for switching patients from one stimulant medication to another?
Discontinue the current medication and start the new one at a starting dose the next day
What are the two forms in which stimulant medications are available?
Sustained-release and immediate-release
How should stimulant medications be monitored?
Regularly monitor for efficacy and side effects
All of the following are common side effects of stimulants EXCEPT
Dizziness, blurred vision, fatigue, muscle weakness
When are clients more likely to experience a 'crash' with stimulant medications?
After taking immediate-release medications
What is the recommended time to take stimulant medications to decrease anorexia?
With breakfast
Which neurotransmitters are associated with inefficient information processing in prefrontal circuits?
Norepinephrine and dopamine
Why should occasional urine drug screens be obtained for clients on stimulant medications?
To confirm the presence of amphetamines & other substances of abuse
Which symptom is NOT commonly associated with stimulant use?
Nausea
What may clients experience when the stimulant medication wears off?
A 'crash' or worsening of symptoms
What could be a possible effect of stimulant medications on weight?
Weight loss due to decreased appetite
What is the main difference between NE and DA concerning inefficient information processing in prefrontal circuits?
Different neurotransmitter receptors activated
Which type of medication is recommended for adults with ADHD?
A2 agonists (clonidine, guafacine) or NEDA (bupropoin-Wellbutrin)
All of the following are _____________-symptoms of ADHD: inattention, restlessness, cognitive & emotional impulsivity, executive functioning defictis, & self regulation.
Primary
What scheduled drug level are stimulant medications?
Schedule II
Which of the following is NOT selective attention?
poor problem solving, difficulty completing tasks
Which of the 4 categories is not considered symptoms of ADHD?
Mood swings
Are refills permitted for stimulant medications?
No, no refills are permitted
What diagnostic test must be obtained prior to prescribing stimulants?
ECG (electrocardiogram)
What is the first step in managing symptoms of ADHD?
Obtaining a thorough health history
Which of the 4 below should NOT be prescribed to those with a history of substance abuse?
dexmethylphenidate such as focalin
Which of the following is NOT a symptom of hyperactivity?
Trouble speaking quietly
Which medication, in combination with a stimulant, can increase anxiety?
Selective serotonin reuptake inhibitors (SSRIs)
What can cause or worsen symptoms of tics in individuals with ADHD?
Stimulant medications
What is the recommended time to take stimulant medications to decrease anorexia?
In the morning
ADHD treatment efficacy will be seen within in what time frame?
1 week
Which factor plays an important role in the development of ADHD?
Genetics
What should the NP assess before treating a patient for ADHD?
Bipolar disorder
What diagnostic test must be obtained prior to prescribing stimulants for individuals with a history of cardiac disease?
EKG
Which brain area is responsible for modulating hyperactivity symptoms?
Prefrontal Cortex
What is the main difference between norepinephrine and dopamine concerning inefficient information processing in prefrontal circuits?
Norepinephrine is more involved in arousal
Which symptom is typically NOT reported by adults?
Hyperactivity
What is the age at which ADHD medications are contraindicated?
6 years and younger
What is the effect of abrupt withdrawal of stimulants after prolonged use?
Irritability and rebound symptoms
What is the recommended way to take stimulant medications to decrease anorexia?
Take with breakfast
Which neurotransmitters are associated with inefficient information processing in prefrontal circuits d/t it being "out of tune"?
Norepinephrine and Dopamine
What can cause appetite changes and subsequent weight loss in clients with ADHD?
Stimulant medications
How soon would you expect treatment efficacy for ADHD to be seen?
within the 1st treatment
Which medications are more likely to cause low birth weight in pregnancy?
Stimulant medications
What can clients experience when the stimulant medication wears off, especially with immediate-release medications?
A worsening of symptoms, or 'crash'
What is the main function of the prefrontal cortex in relation to ADHD?
Executive function
How is increased irritability & insomnia treated in ADHD?
With low dose non-stimulant
Which brain loop is responsible for regulating both anxiety and ADHD?
CSTC loop
Are non-stimulants or stimulants contraindicated in breastfeeding?
stimulants
What is the set of skills referred to as 'executive function'?
A set of skills that underlie the capacity to plan, meet goals, display self-control, follow multiple-step directions even when interrupted, & stay focused despite distractions.
What is the effect of an imbalance in NE and DA on the prefrontal cortex?
Inefficient information processing
When the CSTC loop malfunctions what two types of attention are affected?
Selective and sustained
Why should anxiety be considered as an alternative diagnosis when pt. presents with symptoms of ADHD?
Because they are regulated by the same loop (CSTC)
All of the following are risk factor for ADHD EXCEPT?
Maternal stress after pregnancy
What is the mechanism of action of non-stimulant medications in ADHD?
Selective inhibition of presynaptic NE reuptake & enhancement of NE neurotransmission
What is the benefit of non-stimulant medications in ADHD?
Lowering distractibility and improving attention, working memory, & impulsivity
When are non-stimulant medications commonly used in ADHD?
In cases where stimulants are contraindicated or they do not respond to stimulants
What is the role of NE and DA in ADHD?
They play a role in the symptoms and management of many mental health diagnoses
Test your knowledge on ADHD medications, particularly stimulants prescribed for children and adults. Learn about the lifespan considerations when prescribing ADHD medications like methylphenidate, amphetamine, and non-stimulants like atomoxetine. Find out the drug of choice for adults with ADHD.
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