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AHDH THERAPEUTIC EXAM WITH COMPLETE
SOLUTIONS!!
Short acting 4-6 stimulants
- Adderall (dextroamph/amphe)
- Dexedrine (dextroamph)
1.Focalin (dexmethylphenidate)
- Methylin /Ritalin ( Methylphenidate)
Drug of choice for pediatric patient 5- methylphenidate (ritalin/methylin) or dexmethylphenidate (focalin) alt: ldx/dexamp. mixamp/ ampi
last line: Atomoxetine Bupropion clonidine
Benefits of short-acting stimulants
- initial treatment
- all generics = less expensives
- DOC for <6years or <16kg
- Good add on if intermediate need afternoon dose
BBW of Adderall (Dextroamphetamine/amphetamine) Cardiovascular events
anything capsule can be sprinkled
- metadate CD cap
- Ritalin LA cap
- Mydayis
- Focalin XR
- Aptensio
- Vyvanse
Long Acting stimulants
- dexedrine spansule
- Adderall XR
- Vyvanse
- Mydayis
- Concerta
- Daytrana
- Focalin XR
- Apensio XR
- Quillivant XR
- Journay PM
VYVANSE counseling points Take dose in AM with or after food but avoid high fat due to delay Can open cap and dissolve drug in water, yogurt, or orange juice Long term may lead to dependence C-II
DOC for adults with ADHD
- Vyvanse /Dextroamphetamine/ Amphetamine / mix amphetamine
ALT> Methylphenidate(Dex)
Last line Atomoxetine, Bupropion
DOC for patient with Tourette disorder or autism
- Clonidine/Guanfacine tourette-dopamine antagonist
autism - atypical antipsychotic
DOC for bipolar pt
- second generation antipsychotic, Lithium, anticonvulsant
DOC for CD/ODD Stimulant
alt atomoxetine or clonidine/guanfacine
last line SDA
substance abuse or diversion atomoxetine bupropion
How to manage reduced appetitie and wt loss with stimulants
- High calorie intake at breakfast and bedtime
- cyproheptadine HS
How to mange stomachache
- take on full stomach
- lower dose
How to manage insomnia
- take at early morning
- add guanfacine, clonidine, melatonin, cyproheptadine HS
How to manage irritability/jitteriness
- assess for comorbid conditions such as bipolar
- if positive then decrease dose or d/c and add antipsychotic
Rebound sx
