ADHD

Question 1

Where does ADHD lives?

Answer 1

• The pre frontal cortex

- that is where working memory comes from

Question 2

What age does the PFC finish myelinating?

Answer 2

-25 years old

Question 3

Is there a strong genetic influence for ADHD?

Answer 3

• hell yes!

- gneetic imbalance in DA and noradrenergic systems…. several genes play a role

Question 4

Subtypes of ADHD

Answer 4

• Predominately inattentive type
• predominatley hyperactive-impulsive- start at 4 yr, max 6-8 yr
• combined type is the most common **

Question 5

Diagnositc criteria- inattention

Answer 5

• careless mistakes
• difficulty sustaining attention
• does not seem to listen
• does not follow through on tasks
• not organized
• avoids sustained mental effort
• loses things
• is easily distracted

Question 6

Diagnositc Criteria- hyperactivity/impulsivity

Answer 6

• fidgets or squirms
• inappropriately leaves seat
• inappropriately runs or climbs
• has difficulty playing quietly
• is “on the go”
• talks excessively
• blurts out answers

Question 7

What is the “filter in our brain”

Answer 7

-the PFC

Question 8

Is ADHD a chronic illness?

Answer 8

-yes

Question 9

Diagnositc evaluation for ADHD

Answer 9

• child’s hx and functioning
• family hx and functioning
• school information
• rating scales- parent and teacher
• interview and physical exam of child
• consider psychological/educational evaulation
• computer diagnositc: TOVA, IVA-CPT

Question 10

What do we do for medical tx of adhd?

Answer 10

• Monitor or treat co-morbidities
• educate pt and family
• set goals with family and school
• ADHD is a chronic disorder…. 65% of children with ADHD will have sx as adolexcents

Question 11

What is the most effective tx for ADHD?

Answer 11

• medication!
• good behavior management program
• 70-80% of children will respond to stimulants

Question 12

What are some common stimulant side eects?

Answer 12

• decreased appetite- give with or after meals
• difficulty falling asleep
• tics
• stomachaches, give with food
• headaches

Question 13

What is the movement center in the brain that is associated with tics… involuntary movements?

Answer 13

-the caudate!!!

Question 14

What are the stimulants?

Answer 14

• methyphenidate products
• D-MPH
• D-amphetamine
• Mixed salts

Question 15

Cardiac warnings

Answer 15

• don’t use stimulant if heart disease
• concern about patients with undiagnosed heart disease and long term effects
• EEF not needed if cardiac hx is negative

Question 16

Should ADHD ppl be on medicine when behind the wheel of a car?

Answer 16

-yes! god yes

Question 17

non stimulant meds

Answer 17

• atomoxetine
• bupropion, imipramine
• alpha 2 agonists- clonidine or guanfacine… useful for tics, sleep, and aggression