PMHNP 7348.01 Final
Which of the following is true regarding psychostimulants? - ✔✔First line treatment for ADHD
Stimulants are first line treatment for ADHD in children, adolescents and adults. They are the
most stud
...
PMHNP 7348.01 Final
Which of the following is true regarding psychostimulants? - ✔✔First line treatment for ADHD
Stimulants are first line treatment for ADHD in children, adolescents and adults. They are the
most studied (Dulcan).
ll of the following are changes that were made to the DSM V regarding ADHD? - ✔✔Changed
age of onset to 12
CAN have Autism and ADHD and added symptoms across the lifespan since we know ADHD
does not go away
Can have ADHD and ODD comorbid.
Also included in DSM under ADHD comorbidity- discusses that ADHD and ODD are comorbid
50% of the time
modifiers were added so that the severity of the disorder (i.e., mild, moderate, or severe) can be
specified and the disorder can be coded as "in partial remission"
ADHD treatment is associated with a ... - ✔✔Decrease in accidental injury and medical
utilization due to accidents and trauma
Stimulants have a black box warning for: - ✔✔Drug Dependence
The U.S. Food and Drug Administration (FDA) reviewed the prescribing information on
stimulants in an effort to clarify risks and benefits. After this careful review, the only black box
warning for stimulants concerns their abuse potential" Screen for cardiac concerns.
Which of the following is true regarding cortical brain development in children with ADHD
compared to healthy controls? - ✔✔The timing of cortical maturation is different
Peak thickness of cortex delayed (typically occurs around 7, may not happen until 10 for kids
with ADHD)
Paroxetine (Paxil) and atomoxetine (Strattera) - ✔✔Paroxetine (Paxil) is an inhibitor of CYP450
2D6 and atomoxetine (Strattera) is metabolized by CYP450 2D6, so the dose of atomoxetine
should be decreased.
Strattera as it is metabolized (get rid of d and c)by the P450 CYP 2D6, which many other
psychiatric medications are also metabolized by. Specifically if you look under epocrates for
interactions you will find "avoid combo, combo may increase atomoxetine levels, risk adverse
effects" therefore you'd want to decrease the Strattera dose (or not use the combo)
Which of the following is a risk factor for the development of Conduct Disorder - ✔✔Poor
family functioning
child maltreatment, overly harsh and abusive parenting or inconsistent parenting, neglectful
parenting
Which of the following symptom is the MOST frequent reason for referral in child psychiatry
clinics? - ✔✔Disruptive behavior
"disruptive behavior disorders being the most frequent referral problem for youth, accounting for
one-third to half of all cases seen in mental health clinics" and slide 43 and 44 I mentioned this
during the lecture.
Amphetamine preparations Short-acting considerations - ✔✔Short-acting stimulants often used
as initial treatment in small
children (<16 kg/35 lb), but have
disadvantage of b.i.d.-t.i.d.
dosing to control symptoms
throughout day
Amphetamine x3 preparations Short-acting - ✔✔Adderalla 5, 7.5, 10, 12.5, 15, 20, 30 mg tab
Dexedrine 5 mg cap
DextroStat 5, 10 mg cap
Adderall 5, 7.5, 10, 12.5, 15, 20, 30 mg tab - ✔✔Typical starting Dose
3-5 y: 2.5 mg q.d.
>6 y: 5 mg q.d.-bid
FDA Max 40 mg
Off Label Max Daily >50 kg/100lb: 60 mg
Dexedrine (dextroamphetamine) 5 m
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