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Ped Behavior
behavior disorders
| Question | Answer |
|---|---|
| ASD Medications | Second generation antipsychotics: risperidone (Risperdal) -- 5+ aripiprazole (Abilify) -- 6+ SSRIs improve mood and reduce anxiety |
| ADHD stimulants Medications | Lisdexamfetamine dimesylate (Vyvanse) dextroamphetamine/amphetamine (Adderall; Adderall XR) methylphenidate (Ritalin; Concerta) dexmethylphenidate (Focalin) |
| Stimulant MOA | increase the availability of both dopamine and norepinephrine in prefrontal cortex |
| Stimulant side effects | loss of appetite, insomnia, weight loss, headache, nausea, vomiting, abdominal cramps, increased blood pressure and heart rate, and, potentially, worsening of motor tics |
| Antidepressants side effects | nausea, weight gain or sleep problems |
| Antidepressants MOA | General aim to increase monoaminergic neurotransmission by blocking monoamine reuptake |
| Nonstimulant selective norepinephrine reuptake inhibitors MOA | reducing the degradation of neurotransmitters in the brain, such as norepinephrine, serotonin, and dopamine. |
| ADHD nonstimulants Medications | atomoxetine (Strattera) [nonstimulant selective reuptake inhibitor] Alpha-2 adrenergic agonist clonidine (Catapres) guanfacine (Tenex; Intuniv) |
| Antipsychotics MOA | 1st gen- inhibiting dopaminergic neurotransmission 2nd gen- blocking D2 dopamine receptors as well as serotonin receptor antagonist action |
| Nonstimulant side effects | Nausea or vomiting, Headaches, Sleepiness, Dizziness, Stomachaches, Fatigue, Irritability, Decreased appetite, and Mood swings. |
| Antipsychotic Indications | Tourette's syndrome Behavioral symptoms associated with autistic disorder Severe aggression |
| Antipsychotic side effects | blurred vision, constipation, difficulty urinating, drowsiness, dry mouth, erectile dysfunction, hallucinations, bed-wetting, and confusion and agitation |
| ODD Medications Indications - primary use | FDA has no approved drugs for ODD primary med use is r/t controlling anger and aggression Tx comorbid conditions; ADHD*, depression, and anxiety |
| Conduct disorder Medications | Meds: tx comorbid conditions Antidepressants, mood stabilizers, stimulants, antipsychotics, anticonvulsants, & adrenergic meds |
| Anorexia Nervosa Medications | No meds used to treat SSRI’s if OCD behaviors after pt has reached maintenance weight |
| Bulimia Nervosa Medications | SSRI antidepressant (fluoxetine, Prozac) |
| Binge Eating disorder Medications | SSRI antidepressant--best option to try first b/c of more tolerable side effects and no risk of abuse Vyvanse (tx ADHD): FDA approved for BED in adults; several side effects Tx for obesity (help with wt loss & suppress appetite) |
| Tourette's Medications - First Generation | First generation antipsychotics: haloperidol (Haldol) & pimozide (Orap) |
| Tourette's Medications - Second generation | Second generation antipsychotic Aripiprazole (Abilify) Risperidone (Risperdal) – not FDA approved for tics Alpha-2 adrenergic agonist clonidine (Catapres) Guanfacine (Tenex/Intuniv) |
| Tourette's Medications - Indications | Not often recommended unless causing significant functional impairment or physical discomfort or interfering with overall quality of life |
| Stimulant and Non stimulant interactions | S- Acidic foods and caffeine NS - Some BP medications, MOAIs,, some dietary supplements |
| Stimulant Nurse stuff- Assessment | Monitor for Sudden psychosis or suicidal idealization Monitor weight, appetite, diet, and sleep patterns |
| Antipsychotic Contraindicated | Hx of seizure disorder, cardiac abnormalities, use of anticholinergic or CNS depressants, or a hx of ongoing tardive dyskinesia. |
| Nonstimulant Contraindicated | Sever cardiac disorder or vascular disorder liver problems |
| Nonstimulant Nurse stuff | Monitor BP and HR Monitor for Sudden psychosis or suicidal idealization Teach to take every day to be effective |
| SSRI - Antidepressants Contraindicated | Should not be used with MAOIs, linezolid, or other serotonin-raising drugs that might cause life-threatening serotonin syndrome. |
| First gen antipsychotic adverse effects | Dry mouth, constipation, urine retention. Sedation, reduced seizure thresholds. Vessel arrhythmia, orthostatic hypotension. Photosensitivity, allergic dermatitis. Rare side effects: leukopenia, thrombocytopenia, blood dyscrasia. |
| Second gen antipsychotic adverse effects | less side effects than previous generations. Can cause cause metabolic syndrome and weight gain. orthostatic hypotension, dizziness, anxiety, sleepiness, temperature sensitivity, appetite, somnolence, Monitor for diabetes, dyslipidemia |
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