Most common neurodevelopmental disorder in children, occurring almost twice as often in boys compared to girls

ADHD

ADHD is characterized by symptoms of

inattention, hyperactivity and impulsivity

What catecholamine can play a role in ADHD

defects in the dopamine pathways that regulate reward anticipation and emotion self-regulation

Primary treatment of ADHD

stimulant medication because they raise dopamine and NE levels

First-line treatment for preschool-aged children (age 4-5 years)

parent training in behavior management and/or behavioral classroom intervention

ADHD medications are considered first-line in patients

≥ 6 years old

Natural products that can help with ADHD

Fish oil (improve cognitive function) and melatonin (to help with sleep)

Long-acting formulations are preferred for children, to help

maintain more steady symptom control and avoid the need for a dose during the day at school

Brand name for atomoxetine

Strattera

What is the place of therapy for atomoxetine

can be tried when stimulants do not work well enough (after 2-3 medications)

Brand name for guanfacine ER

Intuniv

Brand name for clonidine ER

Kapvay

guanfacine ER and clonidine ER are non-stimulant medications that can be used

alone or in combination with stimulants

Which stimulant capsule contents can be mixed in water, orange juice or yogurt

Vyvanse

Adderall XR and Ritalin LA capsule contents can be sprinkled on

a small amount of applesauce

all stimulants are C-II and must be dispensed with a

MedGuide

MOA of stimulants

blocks the reuptake of NE and dopamine

Methylphenidate transdermal patch

Daytrana

Brand names for methylphenidate

Ritalin, Concerta, Quillivant, QuilliChew ER, Daytrana

Brand name for methylphenidate OROS delivery

Concerta

How does OROS delivery work

the outer coat dissolves fast to provide immediate action, and the rest is released slowly (decreases abuse potential)

How to apply Daytrana

apply 2 hours before desired effect (or as soon as the child awakens so it starts to deliver prior to school); remove after 9 hours, alternate hips daily

active isomer of methylphenidate

dexmethylphenidate

Brand name of dexmethylphenidate

Focalin

prodrug to dexmethylphenidate

serdexmethylphenidate

Brand names of dextroamphetamine/amphetamine

Adderall, Mydayis

prodrug of dextroamphetamine

lisdexamfetamine

Vyvanse formulations

capsule, chewable tablet

Brand name for methamphetamine

Desoxyn

What formulation is QuilliChew ER

chewable tablet

What formulation is Quillivant XR

oral suspension

MOA of viloxazine

selective NE reuptake inhibitor (approved in patients 6 years and older)

Brand name of viloxazine

Qelbree

Stimulants can cause

increased HR and BP, serious cardiovascular events, insomnia, psychosis, priapism, decreased appetite

atomoxetine can cause

liver damage, suicidal ideation, somnolence

What does ADHD stand for

Attention deficit hyperactivity disorder