ADHD

Question 1

What does ADHD treatment rely on predominantly ?

Answer 1

Relies on precribing stimulant medications of which methylphenidate is most widely used.

Question 2

ADHD?

Answer 2

Attention deficit hyperactivity disorder (ADHD) is a disorder that
manifests in childhood with symptoms of
* Hyperactivity
* Impulsivity
* Inattention

Question 3

ADHD Neurotransmitter deficiencies?

Answer 3

Neurotransmitter differences particularly in levels of dopamine, norepinephrine, epinephrine and serotonin.

Question 4

Dopamine and Norepinephrine roles?

Answer 4

Dopamine has been associated with approach and pleasure-seeking behaviours

Norepinephrine plays a role in emotional/behavioural regulation

Question 5

What are additional related conditions with ADHD?

Answer 5

1. Depression
2. Personality disorder
3. Bipolar disorder
4. Obsessive compulsive disorder (OCD)

Question 6

Cure for ADHD?

Answer 6

No cure for ADHD, currently available treatments may help reduce symtoms

Question 7

Commonly used medication for ADHD?

Answer 7

1. Methylphenidate(Ritalin, Concerta and Metadate)
2. Dextroamphetamine (Adderall)

Question 8

ADHD MOA?

Answer 8

Blocking the re uptake of NOR and DOP and facilitating their release. Enables NOR and DOP availability in certain brain regions: PFC and basal ganglia

Question 9

ADHD Psychosocial intervention?

Answer 9

• Healthy diet and exercise- colourants
• Allergy checks - Some children may benefit
• Teachers - understand ADHD- support/modify
  environment is helpful.
• Simple strategies-paying a\en:on - child sits,
  using visual aids, non-verbal reminders
  (improve symptoms).

Question 10

Pharmacotherapy of ADHD?

Answer 10

My Moods Can Attain

• Atomoxetine
• Methylphenidate
• Modafinil
• Clonidine

Question 11

Atomoxetine MOA?

Answer 11

Selective Norepinephrine Reuptake inhibitor (NRI) Also, it increases pre‐frontal dopamine release

Question 12

Atomoxetine T1/2?

Answer 12

Short t1⁄2, high plasma protein binding, metabolised by hepatic enzymes

Question 13

Atomoxetine Indications?

Answer 13

ADHD in children, adolescence and adults

Question 14

Atomoxetine S/E?

Answer 14

GI upset, dry mouth, headache, palpitation, insomnia, sweating,
Pruritis

Question 15

Atomoxetine CI?

Answer 15

GI upset, dry mouth, headache, palpitation, insomnia, sweating,
Pruritis

Question 16

Atomoxetine Trade?

Answer 16

• Trade: Strattera®

Question 17

Methylphenidate MOA?

Answer 17

Norepinephrine–Dopamine Reuptake inhibitor (NDRI)

Question 18

Methylphenidate Chemical Structure?

Answer 18

• It is a phenethylamine derivative which also shares part of its basic
  structure with catecholamines

Question 19

Methylphenidate Half-life

Answer 19

Short t1⁄2, extensive 1st‐pass metabolism, hepatic metabolism

Question 20

Methylphenidate I?

Answer 20

ADHD, narcolepsy

Question 21

Methylphenidate CI?

Answer 21

glaucoma, hyperthyroidism, glaucoma, cardiac disease, Tourette’s syndrome (inherited neuropsychiatric disorder)

Question 22

Methylphenidate Trade?

Answer 22

Trade: Ritalin® | Concerta®

Question 23

Methylphenidate S/E?

Answer 23

headache, dyskinesia, arrhythmia, urticaria, hair loss, blood dyscrasias (anaemia, leucopoaenia,thrombocytopaenia), convulsion

Question 24

Modafinil MOA?

Answer 24

Unclear precise mechanism of action:
oDopamine transported blocker (DAT)
oD2 receptor partial agonist

Question 25

Modafinil I?

Answer 25

ADHD, narcolepsy

Question 26

Modafinil S/E?

Answer 26

delusion, hallucination, anxiety, suicide ideation, chest pain, epistaxis, hypersensitivity reaction (severe)

Question 27

Modafinil CI?

Answer 27

anxiety disorders, renal impairment, children under 18 years

Question 28

Modafinil Trade?

Answer 28

Trade: Provigil®