Georgette Module 3 Questions And Answers

What is a decreased effect of the same dose of a medication overtime? - ANS Tolerance Ex. taking 2 pills of ibuprofen over a period of time so now needing to take 3 pills to achieve the same effect What is it called when there is a tendency of some regions of the brain to react to repeated LOW level bioelectrical stimulation by progressively boosting synaptic discharges thereby lowering seizure thresholds? - ANS Kindling Kindling explanation/definition - ANS process of neuronal membrane threshold sensitivity dysfunction -d/t subthreshold brain stimulation -brain's overly sensitive to electrical stimuli -neuronal misfiring (occurs w/o stimuli) 3 types of ADHD - ANS Inattention Hyperactivity/impulsivity Combined type Dx criteria for ADHD (all 3 types) - ANS -Hyperactivity & Inattentive type= 6 for children, 5 for adults -Combined type (6 in each area) -6 MONTHS -BEFORE AGE 12 -2 SETTINGS Inattentive ADHD criteria symptoms - ANS 1. Lack of attention to detail 2. Dif. sustaining attention 3. No listen when spoken to directly 4. Doesn't follow through on instruction 5. Dif. organizing tasks/activities 6. Avoids sustained mental effort 7. Loses things 8. Easily distracted 9. Forgetful Hyperactivity ADHD Criteria symptoms - ANS 1. Fidgets/squirms in seat 2. Leaves seat frequently 3. Restless/run or climbs where inappropriate 4. Can't engage in leisure activities QUIETLY 5. Always "on the go" 6. Talks excessively 7. Blurts out answer before question completed 8. Difficulty waiting turn 9. Interrupts others Brain Abnormalities Etiology of ADHD - ANS abnormalities in fronto-subcortical pathway aka the Frontal cortex, Basal Ganglia, RAS Basal Ganglia function - ANS -Motor control/learning -Executive function -Emotions RAS (reticular activating system) - ANS regulates arousal and sleep-wake transitions, ability to focus, fight-flight response What neurotransmitter abnormalities are seen in ADHD?? - ANS Neurotransmitters= **DNS**(DA, NE, 5HT)** Stimulants for ADHD include and what ages are they approved for?? - ANS Adderall (3 and up) Methylphenidate (6 and up) What should you assess prior to giving a stimulant for ADHD? why?? - ANS cardiac hx because they can cause elevated HR & BP, increase risk of MI/CVA/Aneurysm rupture Amphetamines are approved for what age?? - ANS ***age 3 and older*** Methylphenidate is approved for what age?? - ANS **age 6 and older** Non-stimulants for ADHD include - ANS 1. Alpha-agonists/Alpha2 adrenergic agonists= **Clonidine & Guanfacine** (approved ages 6-17 w/ ADHD) 2. Strattera (atomoxetine) approved for >/= 6yr Alpha-agonists FDA approved for ADHD and at what age - ANS Guanfacine & Clonidine ages 6-17 with confirmed dx Strattera (Atomoxetine) is approved for what age in ADHD - ANS >/= 6 years with ADHD ***know** that for children <6 years old, what to give for ADHD - ANS Adderall **Know** what to give when children turn 6 for ADHD - ANS Methylphenidate DNS stands for and what is it?? - ANS DA, NE, 5HT (abnormalities in ADHD and some others) If choosing between Guanfacine & Clonidine for ADHD, which should you choose on the test?? why? - ANS Guanfacine, lasts longer & is less sedating Signs of stimulant abuse?? - ANS **Insomnia **Tremors **Increase in BP & HR **Heart Palpitations Agitation/Anxiety/Irritability/Mood swings/Elevated mood Non Pharmacological management for ADHD includes... - ANS -Behavioral therapy -Pt & Parent CBT program -Psychoeducation