NU553 Unit 3 ADHD Advanced Pharmacology and Pharmacotherapeutics Exam 2

Minimum ADHD symptoms under age 17?

Six

Minimum ADHD symptoms age 17 or older?

Five

ADHD symptoms must start before what age?

12 years

ADHD symptoms must be present in how many settings?

Two settings

Key brain regions in ADHD?

Prefrontal cortex caudate cerebellum

Primary neurotransmitter ADHD reward and attention?

Dopamine

Role of norepinephrine ADHD?

Improves signal to noise focus

Hyperactivity in adults becomes what?

Internal restlessness

Inattention symptoms include what?

Poor organization time management missed deadlines

Methylphenidate mechanism?

Blocks norepinephrine and dopamine reuptake

Amphetamine mechanism?

Blocks reuptake and increases release of norepinephrine and dopamine

First line severe ADHD age 4 to 5?

Methylphenidate

Why lisdexamfetamine less abuse?

Prodrug activation required

Best ADHD drug with substance use history?

Atomoxetine

Atomoxetine mechanism?

Selective norepinephrine reuptake inhibition

Atomoxetine interaction concern?

CYP2D6 inhibitors increase levels

Atomoxetine boxed warning?

Suicidal ideation

Alpha 2 agonists role ADHD?

Tics aggression sleep

Guanfacine vs clonidine?

Less sedation more selective

Bupropion contraindication?

Seizure or eating disorder

Bupropion role ADHD?

Third line option

Stimulant onset?

Same day

Atomoxetine onset?

2 to 4 weeks

Common stimulant adverse effects?

Insomnia appetite loss weight loss

Why drug holidays used?

Reduce growth suppression

Stimulants contraindicated in?

Cardiac disease glaucoma

Max methylphenidate dose?

72 milligrams for some formulations

Monitor with clonidine?

Blood pressure

Atomoxetine severe risk?

Liver injury

Follow up after starting ADHD meds?

Monthly until stable

Who diagnosed more ADHD?

Boys

Adult ADHD screening tool?

Adult Self Report Scale

Why screen for anxiety first?

Can mimic ADHD

Extended release stimulant benefit?

Better compliance steady levels

Concerta release pattern?

22 percent immediate 78 percent delayed

If stimulant fails next step?

Try other stimulant class

Atomoxetine cardiovascular effect?

Increased heart rate and blood pressure

Benzodiazepine interaction caution ADHD?

Central nervous system depressants with alpha agonists

GI side effect stimulant management?

Give with food

Percent ADHD with comorbidity?

More than two thirds

Behavioral therapy role?

Improves function not core symptoms

Adult atomoxetine target dose?

80 milligrams daily

Dexmethylphenidate max dose?

40 milligrams daily

Daytrana formulation?

Transdermal patch

Avoid stimulants in what heart condition?

Structural heart disease

Executive function meaning?

Planning working memory self control

First line ADHD age 5?

Behavioral therapy first

Gene association ADHD?

Dopamine transporter and D4 receptor

Vyvanse starting dose?

30 milligrams daily

Alpha agonist mechanism?

Stimulate alpha 2 receptors

Bupropion risk?

Lowers seizure threshold

Ginkgo role?

Adjunct for concentration

Adult ADHD challenge?

Recall bias childhood symptoms

Atomoxetine preferred when?

Comorbid anxiety or stimulant failure

Ritalin LA vs Concerta?

Burst release vs gradual

Clonidine cardiac effect?

Bradycardia

Compensation in adults ADHD?

Rigid routines list making

Longest acting stimulant example?

Lisdexamfetamine

Hyperactivity symptoms children?

Fidgeting running interrupting

Why get observer history ADHD?

Patient may lack insight

Artificial dyes elimination recommendation?

Not routinely recommended

Catecholamine imbalance causes?

Impaired cognition

Parent training goal ADHD?

Positive reinforcement behavior control

Clonidine max dose?

2.4 milligrams

Atomoxetine slow metabolizer adjustment?

Maintain dose longer

Atomoxetine adult side effect?

Urinary retention

Growth suppression management?

Lower dose or switch

Social skills training purpose?

Improve interpersonal function

Adderall XR max dose?

60 milligrams

Methylphenidate starting dose child?

5 milligrams twice daily

First line ADHD overall?

Stimulants

Main stimulant safety concern?

Cardiovascular effects

Long acting stimulant advantage?

Lower abuse smoother control

Atomoxetine main role?

Nonstimulant alternative

Most common stimulant side effect children?

Appetite suppression

Sleep counseling stimulants?

Take early in day

Alpha agonists benefit?

Hyperactivity impulsivity sleep

Stopping clonidine risk?

Rebound hypertension

Key mechanism difference stimulants?

Release vs reuptake

Why choose atomoxetine?

Substance use concern

Monitor children on stimulants?

Height and weight

If stimulant fails?

Try other class

ADHD vs anxiety board trap?

Anxiety mimics inattention

Common comorbidities ADHD?

Anxiety depression substance use

Why atomoxetine in substance use?

No abuse

Atomoxetine time to effect?

2 to 4 weeks

Stimulant onset speed?

Immediate

Serious stimulant risk?

Tachycardia hypertension

Contraindications stimulants?

Cardiac disease glaucoma hyperthyroidism

Alpha agonist risk?

Rebound hypertension

Executive function deficit?

Planning working memory

Neuro regions ADHD?

Prefrontal cortex caudate cerebellum

Dopamine role ADHD?

Reward attention

Norepinephrine role ADHD?

Focus signal filtering