Card Set Information
Prevelance of ADHD?
3-7% of all children
Symptoms of ADHD in children 3-5 years old?`
Symptoms of ADHD in children 6-12 years old?
incomplete hw, careless errors, struggle to follow instructions, unable to stay seated, talk non-stop, interrupts, hard to wait their turn, defiant
Symptoms of ADHD in 13-18 year old teens?
disorganized, procrastinate, inner restlessness, too many things at once, dangerous driving, defiant, poor self-esteem, anger, poor peer relationships
Symptoms of ADHD in adults?
broken into personally and professionally
divorce, broken relationships, fear, restlessness, risk taking, unplanned pregnancy, criminal activity, late appointments, unfinished multi-tasker
Name the comorbidities along with ADHD\
children- oppositional defiant disorder (ODD) (50%)
adults- anxiety disorder (47%)
other- depression, bipolar disorder, tic disorder
How would you diagnose a patient with ADHD?
scales- specific for age
parent, teacher, patient
Name the 3 types of ADHD
Predominantly inattentive (females, adolescents)
predominalty hyperactive-impulsive- (15% in children, virtually non-existant in adults)
What is the primary method to treat ADHD?
What is the primary choice of medication to treat ADHD?
stimulants: methylphenidate, dexmethylphenidate, mixed amphetamine salts, lisdexamphetamine
Name the short-acting stimulants.
mixed amphetamine salts (Adderall)
Frequency of methylphenidate CD (Methadate CD)?
covers 8 hours
30% released immediately then 70% delayed release
release of methylphenidate (Ritalin LA)
covers 8 hours
50% of dose immediately released
50% released 3-4 hours later
Frequency of Focalin XR
covers 12 hours
Onset of methylphenidate (Daytrana) patch?
onset of 2 hours, coverage of 3 hours after removal of patch
Duration of Adderall XR
Duration of lisdexamphetamine (Vyvanase)?
Describe the steps in first initiating a new ADHD dose.
ped guidlines applied to adults too
immediate release for starting therapy
titrate every 3 to 5 days
go to ER form once immediate release dose is reached.
efficacy of stimulants?
higher doses = better outcome
70% of adolescents and children respond
25-78% of adults respond
How would you treat the SE of tics with ADHD tx?
not common <1%
d/c if clearly worsened
anti-tic (haldol, pimozide)
What would the emergence of depression or mood lability indicate?
toxicity or rebound
rule out substance abuse
If sleep disturbances become an issue, what can you do?
check sleep patterns, adjust time of med
add clonidine, trazodone, mirtazepine, melatonin
What medication can increase appetite in a patient who is experiencing appetite suppression as a SE?
cyproheptadine 2 mg qid
Name a non-stimulant med
efficacy usually seen after 2-6 weeks
some patients say after 3-4 months it doesn't work anymore
Name some atomoxetine SE
Tachycardia, arrgythnia, sudden death
If a patient is on a 2D6 inhibitor such as paroxetine and fluoxetine what needs to happen to the atomoxetine dose?
needs to be reduced
Name a stimulating anti-depressant that can be used for ADHD