Term
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Definition
-Attention Deficit Hyperactivity Disorder
-inattention and/or hyperactivity-impulsivity
-one of the most prevalent childhood disorders
-can continue through adulthood
-can't develop as an adult |
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Term
|
Definition
-1980-ADD
-1987-ADHD or undifferentiated ADD
-1994-ADHD, combined, predom inattentive, predom hyper-active-impulsive |
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Term
| prevalence of ADHD:childhood |
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Definition
-9.5% of children 4-17 diagnosed
-rising since 1990s
-15-20% school age children show transient ADHD behaviors
-males are 3x more likely to have it |
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Term
| what percentage of children with ADHD will have significant symptoms as adults |
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Definition
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Term
|
Definition
-inattention
-hyperactivity
-impulsivity |
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Term
|
Definition
-6+ symptoms
-most are combined type
-symptoms before age 7 for at least 6 months
-present in 2 or more settings
-clinically significant impairment
-symptoms not attributed to another disorder |
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Term
| rule outs for diagnosis of ADHD |
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Definition
-seizure disorder or other neuological issue
- (ex. Tourette's)
-specific learning disability
-genetic disorder
-child psychiatric problem
-problems with vision, hearing, metabolism |
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Term
|
Definition
-neurologically-based behavioral issues can keep children from developing normally
-lack of full coordination
-lack of complete age appropriate speech, language, communication
-diminished executive functions
-deficient self regulation of behavior, mood, response
-impaired ability to organize or plan behavior
-inability to direct behavior toward the future |
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Term
|
Definition
-30-40% will drop out of school
-50-70% few or no friends
-70-80% under perform at work |
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Term
| percentage of cases of ADHD genetically linked |
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Definition
|
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Term
|
Definition
-defects in frontal, temporal lobes, basal ganglia, and cerebellum
-less electrical activity/reactivity
-3-4% smaller
-faster development of motor cortex |
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Term
|
Definition
| -dopamine and serotonin defects |
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Term
|
Definition
-crosses BBB-lipophilic
-2 stereoisomers
-D and L amphetamine
-D is more potent |
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Term
|
Definition
-enters nerve terminal
-increases release of DA and NE
-block the reuptake of DA and NE
-acting in synapse |
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Term
| amphetamine intended effects |
|
Definition
-increase wakefulness, focus
-decrease fatigue, decrease appetite
-relaxation of bronchial smooth muscle |
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Term
|
Definition
-dec. appetite
-delayed sleep onset
-rebound hyperactivity (after drug wears off, more hyper)
-irritability
-tics
-psychosis |
|
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Term
| amphetamine cardiovascular/GI/other SE |
|
Definition
-hypertension
-inc. HR
-arrhythmias
-GI upset
-diarrhea
-nausea
-dry mouth
-slowed height growth
-flushing and sweating |
|
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Term
| amphetamines cautions and warnings |
|
Definition
-not for pts with CV disease
-monitor pts with seizure, psychosis, bipolar
-potential for dependence and addition
-only ST use as an appetite suppression
-not for pts taking MAOI (inc amph levels) within the last 14 days |
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Term
| amphetamine drug class interactions |
|
Definition
-may increase levels of opioids
-use with antacids may INCREASE drug effectiveness (inc absorption)
-avoid alcohol
-do no take with acidic food, juice, vitamin C (lowers absorption) |
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Term
|
Definition
-short acting 4-6 hours
-intermediate acting 6-8 hours
-long acting 8-12 hours |
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Term
|
Definition
-Tx ADHD, narcolepsy
-Pregnancy C
-CYP metabolism
-interm. half life
-short and long acting |
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Term
| Dextroamphetamine and Amphetamine |
|
Definition
-Tx ADHD, narcolepsy
-pregnancy C
-CYP metabolism
-interm. half life
-short and long acting |
|
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Term
| Lisdexamfetamine dimesylate |
|
Definition
-Tx ADHD
-pregnancy C
-prodrug (converted to d-amph)
-non-CYP metabolism
-interm. half life
-long acting form |
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Term
|
Definition
-Tx ADHD, obesity, narcolepsy
-pregnancy C
-CYP2D6 metabolism
-short half life
-short acting |
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Term
|
Definition
-Tx-ADHD, narcolepsy
-pregnancy C
-hepatic and some CYP metabolism
-short half life
-oral and transdermal, short, interm, long acting |
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Term
|
Definition
-common non-stimulant meds for ADHD
-SNRI
-effects seen in a few days to a week |
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Term
|
Definition
-common non-stimulant meds for ADHD
-sympatholytic-alpha 2 receptor agonist
-6-8 hr duration of action |
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Term
|
Definition
| -excessive daytime sleepiness combined with sudden muscle weakness |
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Term
|
Definition
-irresistible sleepiness
-cataplexy-sudden loss of muscle tone while conscious
-sleep paralysis
-hypnagogic hallucinations
-abnormal REM sleep
-3 million ppl worldwide |
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Term
| pathophysiology of narcolepsy |
|
Definition
-disordered information from hypothalmus
-normally darkness prompts cluster of cells in hypothalmus suprachiasmatic nuclei
-SCN signals to pineal gland to release melatonin |
|
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Term
| possible causes of narcolepsy |
|
Definition
-genetic link to immune system (protein hypocretin helps regulate sleep activity)
-environmental triggers (infections, trauma, stress) |
|
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Term
|
Definition
-tricyclic antidepressants
-SSRIs
-CNS depressant (sodium oxybate)
-lifestyle changes (less stress, more exercise, short naps) |
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Term
|
Definition
-tx narcolepsy, shift work disorder
-CIV
-CYP3A4 metabolism
-interm. half life |
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Term
|
Definition
-tx narcolepsy, shift work disorder
-CIV (less addictive)
-CYP3A4
-interm. half life
-R-enantiomer of modafinil |
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Term
| appetite suppression and obesity |
|
Definition
-1/3 americans obese
-BMI over 30 |
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Term
| appetite suppressants:stimulant action |
|
Definition
-inc serotonin and NE inhypothalmus
-make you feel full
-inc fat metabolism |
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Term
|
Definition
-non amphetamine
-Orlistat (lipase inhibitor, can cause severe liver toxicity)
-rimonabant (cannabinoid antagonist, never made it to market!)
-neuropeptide agonists and antagonists (ongoing research) |
|
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Term
|
Definition
-tx obesity
-CIV
hepatic metabolism
-long half life |
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