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NR606 WEEK 5 QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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NR606 WEEK 5 QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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NR606 WEEK 5 QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
Stimulant Medications: Methylphenidate - ANSWER -Low risk of adverse effects
-Available formulations:
• Ritalin - available in immediate release (IR) and extended release (XR) available in beads that may be
sprinkled on food for children who cannot swallow pills
• Concerta biphasic - combined immediate and delayed release in one medication
• Daytrana - patch applied in AM and removed after 9 hour
Stimulant Medications: Dexmethylphenidate (Focalin) - ANSWER -Available in IR and ER
-More potent than Ritalin
-High risk of adverse effects
Stimulant Medications: Amphetamine (Adzenys) - ANSWER -available in orally disintegrating ER formula
for children who cannot swallow pills
-Avoid prescribing when an MAOI has been used within 14 days
Stimulant Medications: Dextroamphetamine (Adderall) - ANSWER -Available in IR and extended-release
formulations
-Often dosed in morning (IR or XR) with an evening or evening prn (IR) dose if med effects diminish prior
to end of school, study or the workday
-Most abused & diverted prescription stimulant
Stimulant Medications: Lisdexamfetamine (Vyvanse) - ANSWER -Biologically inactive until metabolized by
the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
Non-stimulant medication: Atomoxetine (Strattera) - ANSWER -Noradrenergic (NRI)
-Initial drug of choice for adults with ADHD
,-no abuse potential
-tolerated well when prescribed in BID dosing
-appropriate choice for comorbid substance abuse
-may augment the effects of antidepressants & antianxiety meds
-can be dosed at bedtime if fatigue is noted
-unlikely to worsen tics
Non-stimulant medication: Clonidine - ANSWER -α 2 agonist
• May be taken as monotherapy or with stimulant medications
-enhances precortical function for better mental focus
-appetite neutral
-may help with sleep disturbances, administer at bedtime
-adverse effects:
• sedation, brain fog
-monitor of BP closely during initial titration, risk of hypotension
-tapered to avoid rebound hypertension post discontinuation
Non-stimulant medication: guanfacine - ANSWER -α 2 agonist
• May be taken as monotherapy or with stimulant medications
-may also be used for children with tics, sleep disturbances, or aggression
-tolerability & convenience enhanced by once-daily oral controlled-release formulation
-adverse effects:
• sedation, headache, decreased appetite
-reduced side-effect profile comparable to clonidine
-bedtime administration to avoid daytime sedation
Non-stimulant medication: Bupropion (Wellbutrin) - ANSWER -Norepinephrine Dopamine Reuptake
Inhibitor
-off-label use for ADHD in adults
, -appropriate for clients with concurrent depression or tobacco abuse
Attention-deficit/hyperactivity disorder (ADHD) - ANSWER -one of the most common neuropsychiatric
disorders
-approximately 9.4% of children in the U.S.
-more frequently males than females, ratio 2:1
-symptom burden mild to severe
-characterized by consistent pattern of inattention &/or hyperactivity & impulsivity that interferes with
functioning & development
• affect development of proper cognitive, behavioral, emotional, social, & academic function
-hyperactivity and impulsivity ADHD subtype symptoms: excessive fidgeting or talking, feelings of
restlessness and impatience, frequent interruption, and difficultly playing quietly
-inattentive ADHD subtype symptoms: difficulty organizing tasks, maintaining a routine, and paying
attention to detail
• may not be distinguishable until eight or nine years of age
-primarily disrupts neuronal connections within the frontal lobe & prefrontal cortex
Without early identification and proper treatment, ADHD can cause disruptions in: - ANSWER academic
performance
family stress
difficulties in social relationships
accidental injuries
ADHD is associated with: - ANSWER increased rates of depression & SUD
Symptoms of ADHD - ANSWER -Selective Attention
• Lack of attention to detail
• Careless mistakes
• Not listening
• Losing things
• Diverting attention
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