NR606 FINAL EXAM QUESTIONS WITH CORRECT
ANSWERS NEWLY MODIFIED STUDY GUIDE
QUESTIONS
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
Page 1 of 119
,-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
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
Page 2 of 119
,• 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
Page 3 of 119
, 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
Page 4 of 119
ANSWERS NEWLY MODIFIED STUDY GUIDE
QUESTIONS
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
Page 1 of 119
,-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
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
Page 2 of 119
,• 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
Page 3 of 119
, 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
Page 4 of 119
