NR606 Final Exam with correct |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answers
Stimulant Medications: Methylphenidate - correct 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) - correct answer✔✔-Available in IR and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
ER
-More potent than Ritalin |||\\\ |||\\\ |||\\\
-High risk of adverse effects |||\\\ |||\\\ |||\\\ |||\\\
Stimulant Medications: Amphetamine (Adzenys) - correct 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) - correct 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) - correct answer✔✔-Biologically inactive
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
until metabolized by the body (Prodrug)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Less abuse & diversion potential than other stimulants
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,-Higher-cost medication |||\\\
Non-stimulant medication: Atomoxetine (Strattera) - correct 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 - correct 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 - correct 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) - correct 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) - correct 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: - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔academic performance |||\\\
family stress |||\\\
difficulties in social relationships |||\\\ |||\\\ |||\\\
, accidental injuries |||\\\
ADHD is associated with: - correct answer✔✔increased rates of depression & SUD
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Symptoms of ADHD - correct 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
• Excessive talking
|||\\\ |||\\\
• Blurting things out
|||\\\ |||\\\ |||\\\
• Not waiting for one's turn
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
• Interrupting
|||\\\
-Hyperactivity
• Fidgeting
|||\\\
answers
Stimulant Medications: Methylphenidate - correct 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) - correct answer✔✔-Available in IR and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
ER
-More potent than Ritalin |||\\\ |||\\\ |||\\\
-High risk of adverse effects |||\\\ |||\\\ |||\\\ |||\\\
Stimulant Medications: Amphetamine (Adzenys) - correct 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) - correct 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) - correct answer✔✔-Biologically inactive
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
until metabolized by the body (Prodrug)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Less abuse & diversion potential than other stimulants
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,-Higher-cost medication |||\\\
Non-stimulant medication: Atomoxetine (Strattera) - correct 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 - correct 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 - correct 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) - correct 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) - correct 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: - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔academic performance |||\\\
family stress |||\\\
difficulties in social relationships |||\\\ |||\\\ |||\\\
, accidental injuries |||\\\
ADHD is associated with: - correct answer✔✔increased rates of depression & SUD
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Symptoms of ADHD - correct 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
• Excessive talking
|||\\\ |||\\\
• Blurting things out
|||\\\ |||\\\ |||\\\
• Not waiting for one's turn
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
• Interrupting
|||\\\
-Hyperactivity
• Fidgeting
|||\\\
