QUESTIONS WITH 100% CORRECT ANSWERS
GRADED A+/ NR606 FINAL EXAM LATEST!!
Stimulant Medications: Methylphenidate - ANSWER--Low risk of adverse effects
-Available formulations:
• Ritalin - available in immediate release (IR) and extended release (XR) available
in beads that may be sprinkled on food for children who cannot swallow pills
• Concerta biphasic - combined immediate and delayed release in one medication
• Daytrana - patch applied in AM and removed after 9 hour
Stimulant Medications: Dexmethylphenidate (Focalin) - ANSWER--Available in
IR and ER
-More potent than Ritalin
-High risk of adverse effects
Stimulant Medications: Amphetamine (Adzenys) - ANSWER--available in orally
disintegrating ER formula for children who cannot swallow pills
-Avoid prescribing when an MAOI has been used within 14 days
Stimulant Medications: Dextroamphetamine (Adderall) - ANSWER--Available in
IR and extended-release formulations
-Often dosed in morning (IR or XR) with an evening or evening prn (IR) dose if
med effects diminish prior to end of school, study or the workday
-Most abused & diverted prescription stimulant
,Stimulant Medications: Lisdexamfetamine (Vyvanse) - ANSWER--Biologically
inactive until metabolized by the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
Non-stimulant medication: Atomoxetine (Strattera) - ANSWER--Noradrenergic
(NRI)
-Initial drug of choice for adults with ADHD
-no abuse potential
-tolerated well when prescribed in BID dosing
-appropriate choice for comorbid substance abuse
-may augment the effects of antidepressants & antianxiety meds
-can be dosed at bedtime if fatigue is noted
-unlikely to worsen tics
Non-stimulant medication: Clonidine - ANSWER--α 2 agonist
• May be taken as monotherapy or with stimulant medications
-enhances precortical function for better mental focus
-appetite neutral
-may help with sleep disturbances, administer at bedtime
-adverse effects:
• sedation, brain fog
-monitor of BP closely during initial titration, risk of hypotension
-tapered to avoid rebound hypertension post discontinuation
Non-stimulant medication: guanfacine - ANSWER--α 2 agonist
,• May be taken as monotherapy or with stimulant medications
-may also be used for children with tics, sleep disturbances, or aggression
-tolerability & convenience enhanced by once-daily oral controlled-release
formulation
-adverse effects:
• sedation, headache, decreased appetite
-reduced side-effect profile comparable to clonidine
-bedtime administration to avoid daytime sedation
Non-stimulant medication: Bupropion (Wellbutrin) - ANSWER--Norepinephrine
Dopamine Reuptake Inhibitor
-off-label use for ADHD in adults
-appropriate for clients with concurrent depression or tobacco abuse
Attention-deficit/hyperactivity disorder (ADHD) - ANSWER--one of the most
common neuropsychiatric disorders
-approximately 9.4% of children in the U.S.
-more frequently males than females, ratio 2:1
-symptom burden mild to severe
-characterized by consistent pattern of inattention &/or hyperactivity & impulsivity
that interferes with functioning & development
• affect development of proper cognitive, behavioral, emotional, social, &
academic function
-hyperactivity and impulsivity ADHD subtype symptoms: excessive fidgeting or
talking, feelings of restlessness and impatience, frequent interruption, and
difficultly playing quietly
-inattentive ADHD subtype symptoms: difficulty organizing tasks, maintaining a
routine, and paying attention to detail
, • may not be distinguishable until eight or nine years of age
-primarily disrupts neuronal connections within the frontal lobe & prefrontal cortex
Without early identification and proper treatment, ADHD can cause disruptions in:
- ANSWER-academic performance
family stress
difficulties in social relationships
accidental injuries
ADHD is associated with: - ANSWER-increased rates of depression & SUD
Symptoms of ADHD - ANSWER--Selective Attention
• Lack of attention to detail
• Careless mistakes
• Not listening
• Losing things
• Diverting attention
• Forgetfulness
-Lack of Sustained Attention
• Poor problem solving
• Difficulty completing tasks
• Disorganization
• Difficulty sustaining mental effort
-Impulsivity