NR606 NR 606 FINAL EXAM REVIEW WEEKS 5 8
COVERED QS ANS (LATEST )
DIAGNOSIS & MANAGEMENT IN PSYCHIATRIC
MENTAL HEALTH II PRACTICUM (VERIFIED
ANSWERS)
1. Stimulant Medications: Methylphenidate: -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
2. Stimulant Medications: Dexmethylphenidate (Focalin): -Available in
IR and
ER
-More potent than Ritalin
-High risk of adverse effects
3. Stimulant Medications: Amphetamine (Adzenys): -available in orally
disintegrating ER formula for children who cannot swallow pills
-Avoid prescribing when an MAOI has been used within 14 days
4. Stimulant Medications: Dextroamphetamine (Adderall): -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
5. Stimulant Medications: Lisdexamfetamine (Vyvanse): -Biologically
inactive until metabolized by the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
6. Non-stimulant medication: Atomoxetine (Strattera): -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
7. Non-stimulant medication: Clonidine: -± 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
8. Non-stimulant medication: guanfacine: -± 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
9. Non-stimulant medication: Bupropion (Wellbutrin): -
Norepinephrine
Dopamine Reuptake Inhibitor
-off-label use for ADHD in adults
-appropriate for clients with concurrent depression or tobacco abuse
10. Attention-deficit/hyperactivity disorder (ADHD): -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 11. Without early identification and proper treatment,
ADHD can cause disruptions in:: academic performance family stress
difficulties in social
relationships accidental
injuries
12. ADHD is associated with:: increased rates of depression & SUD
13. Symptoms of ADHD: -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
• Excessive talking
• Blurting things out
• Not waiting for one's turn
• Interrupting
-Hyperactivity
, • Fidgeting
• Leaving one's seat
• Running, climbing
• Trouble playing quietly
14. When is ADHD most often diagnosed: -preschool and elementary
school
• inattentive features become more prominent
15. ADHD Lifespan Considerations: Symptoms Change with Age: -
Young children with ADHD
• often have developmental delays
• may engage in behaviors less mature than peers
-Teens with ADHD at risk for:
• poor academic performance
• problems with driving
• difficulties with social situations
• risky sexual behavior
• substance abuse
->75% of children with ADHD experience symptoms in adulthood
-Adolescents & Adults with ADHD
• may struggle with executive function, attention, working memory
• problems with day-to-day functioning, performance at work,
relationships
16. ADHD is a deficiency of neurotransmitters, mainly _________ &
_________-
: dopamine and norepinephrine
17. ADHD diagnostic criteria: -A pattern of at least six symptoms of
inattention and/or hyperactivity-impulsivity that interfere with
functioning or development.
-Symptoms persist for six months or longer.
-Symptoms interfere with social, academic, or occupational functioning.
-Symptoms are present in two or more settings
• for instance, home & school
COVERED QS ANS (LATEST )
DIAGNOSIS & MANAGEMENT IN PSYCHIATRIC
MENTAL HEALTH II PRACTICUM (VERIFIED
ANSWERS)
1. Stimulant Medications: Methylphenidate: -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
2. Stimulant Medications: Dexmethylphenidate (Focalin): -Available in
IR and
ER
-More potent than Ritalin
-High risk of adverse effects
3. Stimulant Medications: Amphetamine (Adzenys): -available in orally
disintegrating ER formula for children who cannot swallow pills
-Avoid prescribing when an MAOI has been used within 14 days
4. Stimulant Medications: Dextroamphetamine (Adderall): -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
5. Stimulant Medications: Lisdexamfetamine (Vyvanse): -Biologically
inactive until metabolized by the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
6. Non-stimulant medication: Atomoxetine (Strattera): -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
7. Non-stimulant medication: Clonidine: -± 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
8. Non-stimulant medication: guanfacine: -± 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
9. Non-stimulant medication: Bupropion (Wellbutrin): -
Norepinephrine
Dopamine Reuptake Inhibitor
-off-label use for ADHD in adults
-appropriate for clients with concurrent depression or tobacco abuse
10. Attention-deficit/hyperactivity disorder (ADHD): -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 11. Without early identification and proper treatment,
ADHD can cause disruptions in:: academic performance family stress
difficulties in social
relationships accidental
injuries
12. ADHD is associated with:: increased rates of depression & SUD
13. Symptoms of ADHD: -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
• Excessive talking
• Blurting things out
• Not waiting for one's turn
• Interrupting
-Hyperactivity
, • Fidgeting
• Leaving one's seat
• Running, climbing
• Trouble playing quietly
14. When is ADHD most often diagnosed: -preschool and elementary
school
• inattentive features become more prominent
15. ADHD Lifespan Considerations: Symptoms Change with Age: -
Young children with ADHD
• often have developmental delays
• may engage in behaviors less mature than peers
-Teens with ADHD at risk for:
• poor academic performance
• problems with driving
• difficulties with social situations
• risky sexual behavior
• substance abuse
->75% of children with ADHD experience symptoms in adulthood
-Adolescents & Adults with ADHD
• may struggle with executive function, attention, working memory
• problems with day-to-day functioning, performance at work,
relationships
16. ADHD is a deficiency of neurotransmitters, mainly _________ &
_________-
: dopamine and norepinephrine
17. ADHD diagnostic criteria: -A pattern of at least six symptoms of
inattention and/or hyperactivity-impulsivity that interfere with
functioning or development.
-Symptoms persist for six months or longer.
-Symptoms interfere with social, academic, or occupational functioning.
-Symptoms are present in two or more settings
• for instance, home & school
