ADHD

Question 1

ADHD diagnosis

Answer 1

at least 6 symptoms of (inattention/hyperactivity-impulsivity) present for at least 6 months
several symptoms must have been present before age 12 and in 2 or more settings (home, school)

Question 2

What are the patient-friendly formulations for stimulants?

Answer 2

capsules (can be opened)
chewable tabs (Vyvanse)
ODT
patches (Daytrana)
suspensions

use small amount of food, do not warm, do not chew

Question 3

ADHD treatment

Answer 3

First-line (take in AM except Jornay):
Concerta, Daytrana, Ritalin, Jornay PM
Vyvanse
Adderall, Adderall XR

Second-line (non-stimulants):
atomoxetine, viloxazine

Add-on or alone:
guanfacine ER (Intuniv), clonidine ER (Kapvay)

Question 4

What can be taken to help sleep at night?

Answer 4

clonidine IR
diphenhydramine
melatonin

Question 5

What schedule are all stimlants

Answer 5

CII (MedGuide required)

Question 6

Stimulant contraindications

Answer 6

do not use within 14 days of MAOi

Question 7

Stimulant safety

Answer 7

increased HR and BP (cardiovascular events) - consider ECG, monitor HR and BP
priapism
exacerbation of psychosis
loss of appetite
serotonin syndrome

Question 8

Stimulant MoA

Answer 8

block reuptake of NE and dopamine

Question 9

Stimulants need to be titrated up and/or down?

Answer 9

titrated up every seven days
do not need to be tapered off

Question 10

Ritalin

Answer 10

methylphenidate, IR tab

Question 11

Concerta

Answer 11

methylphenidate, ER tab with OROS delivery

Question 12

Ritalin LA

Answer 12

methylphenidate, ER cap

Question 13

Jornay PM

Answer 13

methylphenidate, ER cap

Question 14

Quillivant XR

Answer 14

methylphenidate, ER oral suspension

Question 15

Daytrana

Answer 15

methylphenidate, patch

Question 16

Benefit of OROS delivery

Answer 16

outer coat dissolves fast for immediate action, rest released slowly
decreases abuse potential
may see ghost tablet in stool

Question 17

How to use Daytrana

Answer 17

apply to hip 2 hours before desired effect
remove after 9 hours
alternate hips daily
discard by flushing down the toilet

Question 18

Focalin

Answer 18

dexmethylphenidate

Question 19

Adderall/Adderall XR

Answer 19

dextroamphetamine/amphetamine
IR tab, ER caps

Question 20

Vyvanse

Answer 20

lisdexamfetamine
caps, chewable tabs

Question 21

Which stimulants have less abuse potential

Answer 21

Concerta
Vyvanse

Question 22

Strattera

Answer 22

atomoxetine

Question 23

Qelbree

Answer 23

viloxazine

Question 24

Kapvay

Answer 24

Clonidine ER

Question 25

Intuniv

Answer 25

Guanfacine ER