37 Questions
What is the primary consideration when deciding between methylphenidate and amphetamine salt for a patient?
The patient's insurance coverage
What is a common side effect of stimulants mentioned in the passage?
Headaches
Why does the doctor tend to start with amphetamine salts?
Because of their training and experience
What is a reason why some patients may prefer one type of stimulant over the other?
No obvious reason, they just prefer it
What is a common symptom that stimulants are used to treat?
Impulsivity
What is a potential problem with using stimulants as an appetite suppressant?
Some patients may not want their appetite suppressed
Why might a doctor switch a patient from one type of stimulant to another?
Because the patient experiences adverse side effects
How do the doctor's two options for treating patients compare?
They are similar but have some subtle differences
What is the outcome of untreated ADHD in adults?
Social disability and low self-esteem
What is the relationship between childhood ADHD and adult ADHD?
Adult ADHD is the final outcome of childhood ADHD
What is a possible result of late environmental insults in individuals with ADHD?
Further brain dysfunction and comorbidities
What can contribute to the development of ADHD in individuals?
Both genetic predisposition and early and late environmental insults
What is a potential consequence of untreated ADHD in children?
School failure and social disability
What can be a result of residual effects of ADHD in individuals?
Affects on their entire life beyond childhood
What is the topic of the previous lecture?
The neurobiology of ADHD
What is the target hemoglobin A1C level for medicating diabetics?
Less than 7%
What is the goal of asthma medication?
To reduce bronchospasm to less than twice a week
What is the primary goal of pain management?
To reduce pain by at least 50% of its baseline
What is the typical symptom reduction achieved with psychostimulants?
70% reduction
Why is it important to manage patient expectations in psychiatry?
Because the goal of medication is not to achieve normalcy
What is the primary consideration in determining the target level of medication for diabetes?
Balancing the benefits and risks of medication
What is the primary goal of medication in psychiatry?
To get to the point where the benefit of medication optimally outweighs the risks
Why is it important to consider the risk of hypoglycemia in diabetes medication?
Because it can be dangerous
What is the primary concern when considering stimulant therapy for ADD?
Vital signs and weight monitoring
According to the discussion, what is the potential long-term adverse effect of stimulant therapy on adult height?
A decrease of up to one inch
What is the recommended approach to monitoring vital signs and weight when re!lling stimulants?
Record vital signs and weight at every follow-up
Why is the potential restriction of adult height by one inch significant?
Because some people undergo surgeries to extend their height by one inch
What is the recommended approach to discussing the potential restriction of adult height with patients?
Discuss with patients, especially those from families with relatively short stature
What is the timeframe during which stimulant therapy may lead to a restriction of adult height?
Before adolescence or puberty
What is the primary concern when considering stimulant therapy for males with a family history of short stature?
Restriction of adult height
What is the primary reason why long acting doses are preferred for opioid medication?
To provide a more level tonic phase control and minimize post dose euphoria
What is the main advantage of short acting formulations over long acting formulations?
They allow patients to take the medication only when they need it
What is the primary consideration for choosing between short acting and long acting formulations?
The patient's daily schedule
What is the consequence of taking a long acting formulation on a day when the patient doesn't need it?
Unnecessary post dose euphoria
What is the purpose of using long acting formulations for patients who need consistent control throughout the day?
To provide a more level tonic phase control
What is the main difference between short acting and long acting formulations?
The duration of their effects
What is the primary benefit of using long acting formulations for patients with consistent daily routines?
Reduces the frequency of medication intake
Study Notes
Late Environmental Insults and ADHD
- Late environmental insults, such as substance abuse or social adversity, can lead to further brain dysfunction and comorbidities.
- These individuals are at higher risk for needing intervention and may experience chronic dysfunction.
Adult ADHD
- Untreated or unresponsive ADHD in childhood can lead to secondary effects like low self-esteem, school failure, and social disability in adulthood.
- Adult ADHD is the final outcome of childhood ADHD, resulting from genetic predisposition and early and later environmental insults.
Stimulant and Non-stimulant Medications for ADHD
- The goal of medication in psychiatry is not to achieve normalcy, but to reach a point where the benefit of medication optimally outweighs the risks.
- Psychostimulants can achieve a 70% symptom reduction, which is significant.
Methylphenidate and Amphetamine Salts
- Methylphenidate and amphetamine salts are the two broad categories of stimulants, with subtle differences.
- Sometimes, people respond better to one than the other, with no clear explanation.
- Insurance coverage and access can influence the choice of medication.
Adverse Effects of Stimulants
- Common adverse effects of stimulants include insomnia, tremors, headaches, and appetite suppression.
- Stimulants can increase vital signs, which may be a reason to reconsider therapy.
Monitoring and Considerations
- Vital signs and weight should be recorded at every follow-up when refilling stimulants.
- Long-term use of stimulants before the growth spurt may restrict adult height by up to one inch.
- There is no documented relationship between stimulants and cardiovascular events when used properly.
- Long-acting formulations are best for consistent all-day control, but may not be suitable for patients with varying schedules.
This quiz covers the neurobiological aspects of Attention Deficit Hyperactivity Disorder (ADHD), including environmental insults, brain dysfunction, and comorbidities.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
