Doc 17 (1st draft).docx

Treatment efficacy will be noted within the 1st of treatment.  Increased irritability & insomnia can be treated with a low dose of non-stimulant medication which will allow the client to fall asleep.  Abrupt withdrawal after prolonged use can result in irritability & rebound symptoms. NE &am...

Treatment efficacy will be noted within the 1st of treatment.  Increased irritability & insomnia can be treated with a low dose of non-stimulant medication which will allow the client to fall asleep.  Abrupt withdrawal after prolonged use can result in irritability & rebound symptoms. NE & DA are associated with the symptoms of inefficient information processing in the prefrontal circuits. Rather than deficiency, both are “Out of Tune.” ADHD Lifespan Considerations Pregnancy- Are stimulants or nonstimulants more likely to cause low birth weight? Stimulants Breastfeeding- Are stimulants or nonstimulants contraindicated in breastfeeding clients? Stimulants Children- At what age are ADHD medications contraindicated? 6 years and younger, not approved for ADHD Client Education Clients may note a worsening of symptoms, or “crash” when the medication wears off, especially with immediate-release (IR) medications.​ Medications may cause appetite changes and subsequent weight loss. Take medication with breakfast to decrease anorexia. Neurological Basis Genetics The major genes implicated in ADHD are linked to which NTM? DA & NE What are some other risk factors for ADHD? premature birth, low birth weight, maternal stress during pregnancy, prenatal-substance exposure (including tobacco), adverse childhood environment, psychosocial stress, & inconsistent parenting practice Neuroanatomy Specific symptoms arise from abnormalities within the circuits in the prefrontal cortex. The prefrontal cortex affects Executive function. Executive function- “executive function” refers to a set of skills. These skills underlie the capacity to plan and meet goals, display self-control, follow multiple-step directions even when interrupted, and stay focused despite distractions, among others Neural networks When do symptoms usually become noticeable? around 6-7 years of age Why should anxiety be considered as an alternative diagnosis when patients present with symptoms of ADHD? Anxiety and ADHD are regulated by the same loop- the CSTC loop. When this loop malfunctions, selective and sustained attention are affected, and anxiety symptoms can present. It’s important to differentiate between symptoms of anxiety and symptoms of ADHD Neural signaling True or false: symptoms of ADHD are caused by a deficiency in NE and DA. False: it’s not as issue of deficiency as much as NE and DA acting “out of tune” which causes inefficient information processing in the PFC When NE and DA are out of balance, information processing in the prefrontal cortex can be affected leading to the symptoms of ADHD.