RxPrep Attention Deficit Hyperactivity Disorder (ADHD)

ADHD

What is the most common neurodevelopmental disorder in children?

true

True or False: ADHD is a chronic illness that frequently continues to cause symptoms throughout adolescence and adulthood.

ADHD

characterized by symptoms of inattention, hyperactivity, and impulsivity; often have difficulty focusing, are easily distracted, have trouble staying still, and are frequently unable to control impulsive behavior

stimulant

What drug class is the primary treatment for ADHD?

dopamine, norepinephrine

What 2 neurotransmitters do stimulants increase?

≥6 years

ADHD medications are considered first line in patients who are ________ old.

DSM-5

What is used to diagnose ADHD?

≥6; 6 months; 16

The DSM-5 states ADHD diagnosis requires ________ symptom(s) of inattention or hyperactivity-impulsivity, present for at least ________, in children up to age ________.

fish oils

________ are increasingly used for various psychiatric conditions and may modestly improve cognitive function and behavior in children with ADHD, though data is limited.

melatonin

________ is used to help with sleep onset in individuals taking stimulants.

long

(Long/Short)-acting medications are preferred for children with ADHD.

atomoxetine

________, a non-stimulant medication, can be tried when stimulants don't work well enough.

Strattera

What is the brand name for atomoxetine?

clonidine ER, guanfacine ER

What are 2 non-stimulant medications that can be used alone or in combination with stimulants for ADHD?

Intuniv

What is the brand name for guanfacine ER?

Kapvay

What is the brand name for clonidine ER?

Adderall XR, Ritalin LA

What are 2 examples of stimulant capsules whose contents can be sprinkled on a small amount of applesauce?

Vyvanse

What is an example of a stimulant capsule whose contents can be mixed in water, orange juice, or yogurt?

Vyvanse

What stimulant comes in a chewable tablet?

Daytrana

What stimulant comes in a patch?

methylphenidate

What is the generic name for Daytrana?

methylphenidate

What is the generic name for Ritalin?

morning

At what time of day should stimulants be taken?

Jornay PM

What stimulant can be taken in the evening?

methylphenidate

What is the generic name for Jornay PM?

atomoxetine

What drug is second line for ADHD?

atomoxetine

What drug is taken for ADHD if there's a risk of abuse?

clonidine IR, diphenhydramine, melatonin

What 3 drugs are taken to help sleep at night in patients with ADHD?

2

All stimulants are C-________ medications.

false (all)

True or False: Only specific stimulants require a MedGuide to be dispensed with them.

high potential for abuse and dependence

What is the boxed warning associated with stimulants?

14 days; hypertensive crisis

Stimulants should not be used within ________ of an MAO inhibitor due to the risk of ________ when used together.

MAO inhibitor

What is a contraindication for stimulants?

appetite loss, HTN, increased seizure risk, increased serotonin syndrome risk, priapism, psychosis exacerbation, tachycardia

What are 7 warnings associated with stimulants?

stimulant

drug class that blocks the reuptake of norepinephrine and dopamine

7 days

Most stimulants titrated doses every ________ as needed to reduce adverse effects.

true

True or False: Stimulants do not need to be tapered off when used as directed.

Ritalin

What is the brand name for methylphenidate IR tablets?

Concerta

What is the brand name for methylphenidate ER tablets?

Ritalin LA

What is the brand name for methylphenidate ER capsules?

Daytrana

What is the brand name for methylphenidate transdermal patches?

5 mg BID

What is the initial dosing for Ritalin?

18-36 mg QAM

What is the initial dosing for Concerta?

morning

At what time of day is Daytrana applied?

decreased appetite, headache, insomnia, irritability

What are 4 side effects associated with methylphenidate?

BP, ECG, height, HR, weight

What are 5 monitoring parameters for methylphenidate?

osmotic-controlled release oral delivery system

What does OROS stand for?

Concerta

What methylphenidate brand has an OROS delivery?

OROS

outer coat dissolves fast to provide immediate action and the rest is released slowly; harder to crush which decreases abuse potential

Concerta

Which methylphenidate brand can leave a ghost tablet in stool?

2 hours

Daytrana should be applied ________ before the desired effect.

9 hours

Daytrana should be removed after ________.

hip

Where is Daytrana applied?

daily

How often should Daytrana application sites be rotated?

Focalin

What is the brand name for dexmethylphenidate?

Azstarys

What is the brand name for serdexmethylphenidate/dexmethylphenidate?

dexmethylphenidate

Which is the active isomer, dexmethylphenidate or methylphenidate?

Adderall

What is the brand name for dextroamphetamine/amphetamine IR tablets?

Adderall XR

What is the brand name for dextroamphetamine/amphetamine ER capsules?

misuse can lead to serious CV events and sudden death

What is the boxed warning associated with amphetamine, dextroamphetamine, and combinations?

Vyvanse

What is the brand name for lisdexamfetamine?

chewable tablet, capsule

What 2 dosage forms does Vyvanse come in?

Vyvanse

What stimulant has a low abuse potential?

ER

What clonidine and guanfacine formulation is marketed for ADHD?

SNRI

What drug class is Qelbree (viloxazine)?

SNRI

What drug class is atomoxetine?

suicidal ideation

What is the boxed warning associated with atomoxetine?

MAO inhibitor

What is a contraindication for atomoxetine?

decreased appetite, dry mouth, hypertension, insomnia, somnolence, tachycardia

What are 6 side effects of atomoxetine?

false (ocular irritant)

True or False: Atomoxetine capsules can be opened and sprinkled on food.

central alpha2A agonist

What drug class is clonidine and guanfacine?

Catapres

What is the brand name used in practice for clonidine IR?

bedtime

At what time of day is clonidine ER taken?

QD

How often is guanfacine ER dosed for ADHD?

CV effects, drowsiness, rebound HTN

What are 3 warnings associated with central alpha2A agonists?

rebound HTN

What can happen if central alpha2A agonists are discontinued abruptly?

constipation, decreased HR, dizziness, dry mouth, fatigue, hypotension, somnolence

What are 7 side effects associated with central 2A agonists?

true

True or False: Central alpha2A agonists must be tapered off when discontinuing.