Neurobiology of ADHD

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Questions and Answers

What is the primary consideration when deciding between methylphenidate and amphetamine salt for a patient?

The doctor's training and experience

The patient's insurance coverage (correct)

The patient's medical history

The patient's personal preference for one over the other

What is a common side effect of stimulants mentioned in the passage?

Weight gain

Improved appetite

Insomnia

Headaches (correct)

Why does the doctor tend to start with amphetamine salts?

Because of their training and experience (correct)

Because they are more effective than methylphenidate

Because they are less expensive than methylphenidate

Because they are easier to prescribe than methylphenidate

What is a reason why some patients may prefer one type of stimulant over the other?

No obvious reason, they just prefer it Signup and view all the answers

What is a common symptom that stimulants are used to treat?

Impulsivity Signup and view all the answers

What is a potential problem with using stimulants as an appetite suppressant?

Some patients may not want their appetite suppressed Signup and view all the answers

Why might a doctor switch a patient from one type of stimulant to another?

Because the patient experiences adverse side effects Signup and view all the answers

How do the doctor's two options for treating patients compare?

They are similar but have some subtle differences Signup and view all the answers

What is the outcome of untreated ADHD in adults?

Social disability and low self-esteem Signup and view all the answers

What is the relationship between childhood ADHD and adult ADHD?

Adult ADHD is the final outcome of childhood ADHD Signup and view all the answers

What is a possible result of late environmental insults in individuals with ADHD?

Further brain dysfunction and comorbidities Signup and view all the answers

What can contribute to the development of ADHD in individuals?

Both genetic predisposition and early and late environmental insults Signup and view all the answers

What is a potential consequence of untreated ADHD in children?

School failure and social disability Signup and view all the answers

What can be a result of residual effects of ADHD in individuals?

Affects on their entire life beyond childhood Signup and view all the answers

What is the topic of the previous lecture?

The neurobiology of ADHD Signup and view all the answers

What is the target hemoglobin A1C level for medicating diabetics?

Less than 7% Signup and view all the answers

What is the goal of asthma medication?

To reduce bronchospasm to less than twice a week Signup and view all the answers

What is the primary goal of pain management?

To reduce pain by at least 50% of its baseline Signup and view all the answers

What is the typical symptom reduction achieved with psychostimulants?

70% reduction Signup and view all the answers

Why is it important to manage patient expectations in psychiatry?

Because the goal of medication is not to achieve normalcy Signup and view all the answers

What is the primary consideration in determining the target level of medication for diabetes?

Balancing the benefits and risks of medication Signup and view all the answers

What is the primary goal of medication in psychiatry?

To get to the point where the benefit of medication optimally outweighs the risks Signup and view all the answers

Why is it important to consider the risk of hypoglycemia in diabetes medication?

Because it can be dangerous Signup and view all the answers

What is the primary concern when considering stimulant therapy for ADD?

Vital signs and weight monitoring Signup and view all the answers

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 Signup and view all the answers

What is the recommended approach to monitoring vital signs and weight when re!lling stimulants?

Record vital signs and weight at every follow-up Signup and view all the answers

Why is the potential restriction of adult height by one inch significant?

Because some people undergo surgeries to extend their height by one inch Signup and view all the answers

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 Signup and view all the answers

What is the timeframe during which stimulant therapy may lead to a restriction of adult height?

Before adolescence or puberty Signup and view all the answers

What is the primary concern when considering stimulant therapy for males with a family history of short stature?

Restriction of adult height Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

What is the primary consideration for choosing between short acting and long acting formulations?

The patient's daily schedule Signup and view all the answers

What is the consequence of taking a long acting formulation on a day when the patient doesn't need it?

Unnecessary post dose euphoria Signup and view all the answers

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 Signup and view all the answers

What is the main difference between short acting and long acting formulations?

The duration of their effects Signup and view all the answers

What is the primary benefit of using long acting formulations for patients with consistent daily routines?

Reduces the frequency of medication intake Signup and view all the answers

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.

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Description

This quiz covers the neurobiological aspects of Attention Deficit Hyperactivity Disorder (ADHD), including environmental insults, brain dysfunction, and comorbidities.