What’s New in the Pharmacological Treatment of ADHD in Children
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- Which of the following drugs is not considered a first-line therapy in the treatment of ADHD?
a) OROS methylphenidate
c) Mixed amphetamine salts
d) Immediate-release methylphenidate
All the first line agents are long-acting stimulants. Short-acting methylphenidate is considered a second-line agent.
2. Which of the following statements is false?
a) ADHD is the most common neurodevelopmental disorder in school age children.
b) Of the three clinical presentations of ADHD, the most common is the hyperactive/impulsive subtype.
c) The majority of patients with ADHD have at least one comorbidity.
d) One of the diagnostic criteria in diagnosing ADHD is that symptoms must be present before the age of 12.
Of the three clinical presentations of ADHD, the most common is the combined subtype (combination of inattentive and hyperactive/impulsive).
3. What are the two main neurotransmitters involved in ADHD?
a) norepinephrine and serotonin
b) dopamine and serotonin
c) dopamine and noradrenaline
Dopamine and noradrenaline both play an important role in ADHD. Dopamine is one of the main neurotransmitters that affects attention and noradrenaline is one of the main neurotransmitters that affects hyperactivity.
4. What is the mechanism of action of guanfacine?
a) selective alpha2A adrenergic receptor antagonist
b) selective alpha2A-adrenergic receptor agonist
c) selective alpha2B-adrenergic receptor agonist
d) selective alpha2B-adrenergic receptor antagonist
Guanfacine is a selective alpha2A-adrenergic receptor agonist.
5. Which is a side effect associated with guanfacine but not with psychostimulants?
b) abdominal pain
d) weight loss
Contrary to pschostimulants, guanfacine can cause hypotension. Headaches and abdominal pain are possible with both guanfacine and psychostimulants. Weight loss is more common with psychostimulants, whereas guanfacine has greater chances of causing weight gain.
6. Which medication does not interact with guanfacine?
b) valproic acid
- Clarithromycin is a strong CYP3A4 inhibitor, therefore it can increase the effects of guanfacine.
- Concentrations of valproic acid can increase when it is combined with guanfacine.
- Like guanfacine, propranolol decreases the heart rate. Combining guanfacine with a beta blocker should be avoided.
- Lisdexamphetamine can be combined with guanfacine. In fact, combining guanfacine with a stimulant can be very effective.
Question 1 of 6
Which of the following drugs is not considered a first-line therapy in the treatment of ADHD?
Question 2 of 6
Which of the following statements is false?
Question 3 of 6
What are the two main neurotransmitters involved in ADHD?
Question 4 of 6
What is the mechanism of action of guanfacine?
Question 5 of 6
Which is a side effect associated with guanfacine but not with psychostimulants?
Question 6 of 6
Which medication does not interact with guanfacine?