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NR606 Final Exam Study Guide Solutions 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 swall...

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  • November 11, 2024
  • 113
  • 2024/2025
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NR606 Final Exam Study Guide Solutions


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

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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

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-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


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-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



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