NR 546 FINAL EXAM WITH VERIFIED QUESTIONS
AND ANSWERS LATEST UPDATED
•Are short-acting or long-acting stimulants at a higher risk for diversion?
•How should these medications be monitored? - •Short-acting medications are at higher
risk for diversion.
•Occasional urine drug screens should be obtained to verify the presence of
amphetamines and the absence of other substances of abuse
•What is the correct protocol for switching patients from one stimulant medication to
another? - •When switching stimulants, discontinue the current medication and start the
new medication at a starting dose the next day.
•What two forms are stimulant medications available in? - •Stimulant medications
available to treat ADHD are available as immediate-release or sustained-release
formulations
Common side effects include? - restlessness, irritability, anxiety, insomnia,
stomachache, headaches, tics, and worsening of aggression symptoms
•Clients may note a worsening of symptoms when the medication wears off
•If this more likely to occur with immediate or sustained-release medications? - •Clients
may note a worsening of symptoms, or "crash" when the medication wears off,
especially with immediate-release (IR) medications
•When should clients take stimulant medications? - •Medications may cause appetite
changes and subsequent weight loss. Take medication with breakfast to decrease
anorexia
•Methylphenidate - •Low risk of adverse effects
•Examples
•Ritalin- available in IR and XR and in beads that can be sprinkled on food
•Concerta- IR and DR combined
•Daytrana- patch applied in AM remove after 9 hours
, •Dexmethylphenidate - •IR and ER forms available
-more potent than Ritalin
-high risk of adverse effects
•Amphetamine (adzenys) - •orally-disintegrating ER for children who cannot swallow
pills
-avoid prescribing when MOAI has been used with 14 days
•Dextroamphetamine (Adderall)- - •IR and ER
•Often dosed in AM (IR or XR) with a PM or PM PRN (IR) dose if medication effects
diminish prior to the end of school, duty, or the workday
-most abused and diverted prescription stimulants
•Lisdexamfetamine (Vyvanse)- - •biologically inactive until metabolized by the body
(prodrug)
-less abuse and diversion potential than other stimulants
-higher cost medication
which NT play a role in the symptoms & treatment of ADHD? - norepinephrine &
dopamine
ADHD symptoms 4 categories - selective attention, hyperactivity, lack of zsustained
attention, impulsivity
what is the youngest age ADHD can appear at? - 3 y/o
what plays an important role in the development of ADHD? - genetics
Describe selective attention? - lack of attention to detail, careless mistakes, not
listening, losing things, diverting attention, forgetful
Describe lack of sustained attention? - poor problem solving, difficulty completing tasks,
disorganization, difficulty sustaining mental effort
what is impulsivity ? - excessive talking, blurting things out, not waiting one's turn,
interrupting
what is hyperactivity? - fidgeting, leaving one's seat, running, climbing, trouble playing
quietly
AND ANSWERS LATEST UPDATED
•Are short-acting or long-acting stimulants at a higher risk for diversion?
•How should these medications be monitored? - •Short-acting medications are at higher
risk for diversion.
•Occasional urine drug screens should be obtained to verify the presence of
amphetamines and the absence of other substances of abuse
•What is the correct protocol for switching patients from one stimulant medication to
another? - •When switching stimulants, discontinue the current medication and start the
new medication at a starting dose the next day.
•What two forms are stimulant medications available in? - •Stimulant medications
available to treat ADHD are available as immediate-release or sustained-release
formulations
Common side effects include? - restlessness, irritability, anxiety, insomnia,
stomachache, headaches, tics, and worsening of aggression symptoms
•Clients may note a worsening of symptoms when the medication wears off
•If this more likely to occur with immediate or sustained-release medications? - •Clients
may note a worsening of symptoms, or "crash" when the medication wears off,
especially with immediate-release (IR) medications
•When should clients take stimulant medications? - •Medications may cause appetite
changes and subsequent weight loss. Take medication with breakfast to decrease
anorexia
•Methylphenidate - •Low risk of adverse effects
•Examples
•Ritalin- available in IR and XR and in beads that can be sprinkled on food
•Concerta- IR and DR combined
•Daytrana- patch applied in AM remove after 9 hours
, •Dexmethylphenidate - •IR and ER forms available
-more potent than Ritalin
-high risk of adverse effects
•Amphetamine (adzenys) - •orally-disintegrating ER for children who cannot swallow
pills
-avoid prescribing when MOAI has been used with 14 days
•Dextroamphetamine (Adderall)- - •IR and ER
•Often dosed in AM (IR or XR) with a PM or PM PRN (IR) dose if medication effects
diminish prior to the end of school, duty, or the workday
-most abused and diverted prescription stimulants
•Lisdexamfetamine (Vyvanse)- - •biologically inactive until metabolized by the body
(prodrug)
-less abuse and diversion potential than other stimulants
-higher cost medication
which NT play a role in the symptoms & treatment of ADHD? - norepinephrine &
dopamine
ADHD symptoms 4 categories - selective attention, hyperactivity, lack of zsustained
attention, impulsivity
what is the youngest age ADHD can appear at? - 3 y/o
what plays an important role in the development of ADHD? - genetics
Describe selective attention? - lack of attention to detail, careless mistakes, not
listening, losing things, diverting attention, forgetful
Describe lack of sustained attention? - poor problem solving, difficulty completing tasks,
disorganization, difficulty sustaining mental effort
what is impulsivity ? - excessive talking, blurting things out, not waiting one's turn,
interrupting
what is hyperactivity? - fidgeting, leaving one's seat, running, climbing, trouble playing
quietly
