Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Naplex
Attention Deficit Hyperactivity Disorder
| Question | Answer |
|---|---|
| Q1. ADHD diagnosis | • Symptoms were present before age 12 years; • In 2 or more settings (e.g., at home, school, work, with friends or relatives, babysitters); • Symptoms interfere with functioning, and are not caused by another disorder. |
| Q2. Natural product: Fish Oils Polyunsaturated Fatty Acids (PUFAs) | • 4-16 weeks. • Little evidence of benefit. • Limited data of improvement w combined omega-3 and 6 supplementation. |
| Q3. 1st-line drugs, take in AM | • Concerta, Daytrana patch, or Ritalin: methylphenidate • Vyvanse: lisdexamfetamine • Adderall XR and IR (often older patients): amphetamine-dextroamphetamine |
| Q4. 2nd line, or if abuse risk (non-stimulant, not controlled) | • Strattera: atomoxetine • After 2-3 trials of stimulant • ALONE |
| Q5. Often added to stimulants, or used alone | • Intuniv: guanfacine • Kapvay: clonidine |
| Q6. Stimulants: CII | • Methylphenidate • Dexmethylphenidate • Amphetamine/Dextroamphetamine • Dextroamphetamine • Lisdexamfetamine • Methamphetamine |
| Q7. Non-Stimulants | • Atomoxetine Central alpha-2 agonists • Clonidine • Guanfacine |
| Q8. Stimulants BW | • Heart problems, heart defects, high BP, or a family hx • Call your doctor if chest pain, shortness of breath, or fainting. |
| Q9. Stimulants MoA | • Release and block reuptake of Dopamine, Norepinephrine in presynaptic neurons |
| Q10. Stimulants formulation | • Most once-daily, AM • Some capsules: contents sprinkled on a small amount of applesauce and taken immediately— but NOT Vyvanse. • All long-acting tablets/capsules: cannot be crushed, chewed, or cut—except QuilliChew ER |
| Q11. Daytrana patch - Warnings | • Loss of skin pigmentation at application site and areas distant from the application site (can resemble vitiligo) • Allergic contact sensitization with local reactions (e.g., edema, papules) |
| Q12. Stimulants SEs | • Nausea, insomnia, HA, irritability, blurry vision, dry mouth |
| Q13. Stimulant Monitoring | • ECG prior to treatment; • BP and HR, cardiac symptoms • CNS effects • Abuse potential • Height and weight (children) |
| Q14. Jornay PM | • Outer coating delays initial drug release 10 hours to allow for PM dosing • Inner coating controls the slow release of the drug during the day |
| Q15. QuilliChew ER | • Tablets are scored and can be broken in half |
| Q16. Quillivant XR | • Shake bottle for at least 10 seconds prior to use |
| Q17. Daytrana patch | • Apply 2 hrs before desired effect (orASA the child awakens so it starts to deliver prior to school) and remove after 9 hrs • Alternate hips daily |
| Q18. With amphetamines | • Avoid use of acidic foods (e.g., juice or vitamin C) as these can decrease amphetamine levels. |
| Q19. | Some products contain phenylalanine (avoid with PKU). |
| Q20. Vyvanse | • Take whole, or mix with a small amount of water, orange juice or yogurt, do not let it sit. |
| Q21. Atomoxetine (Straterra) BW, CI | • BW: Suicidal ideation; worsening mood, or unusual behavior • CIs: Glaucoma, pheochromocytoma, severe CV disorders, MAOi use within past 14 days • Hepatoxicities (within 4 mos) |
| Q22. Atomoxetine (Straterra) SEs | • HA, insomnia, somnolence, HTN, tachycardia, dry mouth, • Nausea, abdominal pain, reduce appetite, ED, reduce libido, hyperhidrosis |
| Q23. Atomoxetine (Straterra) Monitoring | • HR, BP, ECG, height, weight, agitation • NOT open the capsule - irritant |
| Q24. Guanfacine ext-rel (Intuniv) | • Somnolence, hypotension, nausea, not with high fat meal |
| Q25. Clonidine ext-rel (Kapvay) | • Somnolence, start QHS • Do not stop suddenly...(rebound HTN) |
| Q26. Stimulant MoA | • Block re-uptake norepinephrine and dopamine • Titrate UP every 7 days • NO need to taper off (if used as directed) |
| Q27. Stimulants list | • Methylphenidate • Dexmethylphenidate • Amphetamine, Dextroamphetamine, Amphetamine + Dextroamphetamine • Lisdexamfetamine (prodrug of amphetamine) |
| Q28. DDI of Stimulants and MAO | • Increase norepinephrine • 14 days wash out of MAOi: HTN crisis |
| Q29. DDI of Stimulants and SNRIs, SSRIs | • Additive risk of serotonin syndrome |
| Q30. Methylphenidate formulations | • ODT • ER suspension / chew tab • Transdermal patch |
| Q31. Concerta formulation | • Methylphenidate • Osmotic oral release system (OROS) • Outer: immediate effects • The rest: ER • Once-daily QAM • Ghost tablet |
| Q32. Clonidine brand name | • Kapvay: ER for ADHD, alone or combination w stimulants • Catapres: IR for BP • Central α₂-adrenergic agonists |
| Q33. Baseline monitoring prior starting stimulant | • ECG, heart rate and blood pressure • Children: Height & Weight |
| Q34. WHY Intuniv requires slowly tapering | • Should NOT d/c abruptly 2/2 rebound HTN |
| Q35. Concerta dosing | • 18, 27, 36, 54 mg ER • Start at 18-36mg QD • Titrate by 18 mg/day wkly intervals, as needed |
| Q36. Stimulants safety concerns | • Exacerbation of psychiatric conditions (mania) • Seizures • Delayed growth / children • Priapism |
| Q37. Daytrana patch - counseling | • Alternate hips daily • 2 hrs prior desired effect • Removed after 9hrs • Avoid heat • Folding half, flushing / toilet or placing / lidded trash can |
| Q38. DSM-5 diagnostic criteria for ADHD' | • Blurts out answers • Failure to pay attention • Inability to play quietly • Interrupts others • Easily distracted • 2+ settings |
| Q39. "Blurts out answers" | • Answers a question before it has been completed • Speaks without thinking • Difficulty waiting their turn |
| Q40. Starting dose of Ritalin | • 5mg BID before breakfast and lunch |
| Q41. Prodrug of dextroamphetamine | • Lisdexamfetamine (Vyvanse) |
| Q42. Strattera has a boxed warning | • Suicidal ideation |
| Q43. Vyvanse capsule content can be mixed w | • Orange juice, water or yogurt |
| Q44. Stimulants w chewable tablet | • Vyvanse: Lisdexamfetamine • QuilliChew ER: methylphenidate • Methylin: methylphenidate IR |
| Q45. Possible side effects of Kapvay | • Clonidine extended-release • Central acting alpha-2 agonist • Bradycardia, hyPOtension • Sedation • Rebound HTN (d/c abruptly) |
| Q46. Managing difficulty sleeping caused by Stimulants | • IR / Central acting alpha-2 agonist • OTC diphenhydramine and melatonin |
| Q48. Counseling points for atomoxetine | • Decrease in appetite • Increase BP, HR, • insomnia, somnolence • Dry mouth, nausea and abdominal pain |
| Q49. Stimalants target to neurohormone | • Dopamine • Norepinephrine |
Created by:
dao.vo11017