Transcript ADHD-Pharmacology

Attention Deficit Disorder
Regina Grant
Brief History of ADHD
1902-ADHD was first recognized as a disorder in 1902. A British doctor Dr. Still
documented cases of impulsive behavior. He gave the disorder its first name, “Defect of
Moral Control,” Despite this name, he believed that the disorder was a medical problem,
not a spiritual defect.
1922-It was not until 1922 that ADHD symptoms were described and diagnosed as
“Post-Encephalitic Behavior Disorder.”
1937-In 1937 stimulants were first used to treat children who exhibited signs of ADHD.
This was introduced by one Dr. Charles Bradley.
1956-In 1956, Ritalin came on the market. It was used to treat children considered to be
“hyperactive.”
1960-Throughout the 1960s, stimulants were increasingly used to treat hyperactive
children. In the early part of the decade, the term “Minimal Brain Dysfunction” was used
to describe the disorder, but this was changed to “Hyperkinetic Disorder of Childhood” in
the later part of the decade.
Cont. Brief History
1970-In the 1970, more symptoms were recognized to go along with
hyperactivity. These include impulsiveness, lack of focus,
daydreaming, and other lack of focus type symptoms. “Impulsiveness”
as a category was divided into three subtypes: verbal, cognitive, and
motor impulsiveness. 1980-In 1980 the name “Attention Deficit
Disorder” was invented by American Psychiatric Association.
1987-In 1987, the name was revised to “Attention Deficit Hyperactive
Disorder.”
1996-In 1996, Adderall was approved to treat ADHD.
1998-In 1998, the American Medical Association stated that ADHD
was one of the most researched disorders, despite the fact that its
cause is unknown.
Introduction
Attention Deficit Disorder (ADHD)-a
disorder characterized by ageinappropriate levels of inattention,
impulsiveness, and hyperactivity.
ADHD currently a proper diagnosis,
constituting the largest single reason
children are referred to child mental
health clinics.
ADHD symptoms may be mild, moderate,
or severe.
Symptoms are considered mild when
there are few, if any, in excess of those
required for diagnosis and when there is
little impairment in school and social
functioning.
Diagnosis and
Treatment
The evaluation process for making the
diagnosis usually includes obtaining a
through medical and social history
through interviews with the parents, the
child, and the child’s teacher; a
complete medical examination;
observation
Learning Disabilities
Somewhere around 1-in-4 children
with ADHD will also have a specific
type or learning disability.
In preschool children, this often
appears as a difficulty understanding
certain sounds or words and/or
difficulty in expressing oneself in
words. In school age children,
reading or spelling disabilities,
problems writing, and arithmetic.
One specific type of reading disorder,
dyslexia, is quite common. Reading
disabilities affect up to 8 percent of
elementary school children.
Sleep Disturbance
• Over half of all students with attention deficit
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have significant problems falling asleep or
waking up. Consequently, many families have
major battles every morning just trying to get
the teenager up and ready for school on time.
For occasional sleep problems, doctors may
suggest taking Benadryl or melatonin.
Doctors also may prescribe one of the several
medicines to help with major sleep problems.
Clonidine, Trazadone, and Zyprexa are
commonly prescribed. Seroquel and Tofranil
less often.
Possible Causes of Childhood
ADHD
Genes: ADHD appears to
have some type of genetic
basis in the majority of cases,
as a child with ADHD is four
times as likely to have had a
relative who was also
diagnosed with attention
deficit disorder.
At the moment researchers
are investigating many
different genes, particularly
ones involved with the brain
chemical dopamine.
Whatever the case, I find that loading
my days with blocks of time devoted
to many different activities provides
me with the ability to focus on more
things for more time. It seems a little
counter-intuitive to me at times--it
would seem that someone unable to
focus would do better with more
time to do the things that need to be
done. But I can't deny it: when my
schedule is chock-full, it invigorates
my mind and I'm actually able to
focus more than when I have gobs of
time.
-Sir Matthew Hale
Adderall
Generic Name:
amphetamine and dextroamphetamine
3-5 yrs old-2.5 mg daily, 6-yrs old-5mg once or twice daily, rare cases can
exceed to 40 mg.
Adderall contains a combination of
amphetamine and dextroamphetamine.
Amphetamines and detroamphetamine
are central nervous system stimulants
that affect chemicals in the brain and
nervous that contribute to hyperactivity
and impulse control.
Side Effects: fast, pounding, or uneven
heartbeats, pain or burning when you
urinate
taking more than usual, feeling of
extreme happiness or sadness,
numbness, tingling or strange
sensations under your skin, dry mouth,
anxiety, agitation, stomach pain
Adderall XR
Generic Nameamphetamine &
dextroamphetamine
Dosage: 5mg-30mg
Side effects: fast, pounding, or uneven
heartbeats, pain or burning when your urinate,
talk more than usual, feelings of extreme
happiness, or sadness, numbness, tingling, or
strange sensations under your skin, tremors,
hallucinations, unusual wounds, or skin color
changes (pale, red, or blue appearance in your
fingers and toes.
Quillivant XR
Generic Name: methylphenidate
dosage: 6yrs-20mg, titrated weekly 10 to 20mg, has not been
studied above 60mg
nervousness, trouble
sleeping, loss of appetite,
weight loss, dizziness,
nausea, vomiting, or
headache may occur.
Numbness/pain/skin color
change/sensitivity to
temperature in the fingers or
toes, fast/pounding/irregular
or heartbeat,
mental/mood/behavior
changes (such as agitation,
aggression, mood swings,
abnormal thoughts)
Vyvanse
Generic name:
lisdexamfetamine
Dosage:30mg once daily in the
morning in patient 6 yrs or above.
Dosage may be increase by 10mg
or 20mg and the max is 70 mg
Side effects: nausea, dry mouth, loss of
appetite, stomach/abdominal pain,
headache, nervousness, dizziness, trouble
sleeping, sweating, weight loss, irritability,
and restlessness may occur.
Serious side effects: blurred vision, fast
pounding/irregular heartbeat,
mental/mood/behavior changes (such as
agitation, aggression, mood swings,
depression, hallucinations, abnormal
thoughts/behavior)
Concerta
Generic Name: methylphenidate
Dosage: 6-12 yrs-18mg-54mg/day, 13-17yrs-18mg-72mg/day,
18-65 yrs- 18 or 65mg/day or up to 72mg/day-tablet or extended release
Fast heartbeat-more common
Chest pain-less common, fever, joint
pain, skin rash or hives
Rare-black, tarry stools, blood in the
urine or stools, blurred vision,
convulsions, crusting, dryness, or
flaking of the skin, muscle cramps,
pinpoint red spots on the skin,
uncontrolled vocal outbursts or tics,
unusual bleeding or bruising
Incidence not known-confusion,
feeling like surroundings are not real,
depression
Art Therapy for
Children with
ADHD
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The arts can be great vehicle in this
endeavor. Engaging in creative
activities such as art, music and dance
have been shown to help children with
ADHD calm down because it utilizes
the part of the brain that controls
emotions.
When the emotions are under control,
the focusing is much easier.
Playing Minecraft with ADHD
Minecraft is widely popular game,
with a huge virtual world for
children to explore, build and play
in. With nearly set goals, players
are free to set out and set their own
objectives, mining out resources in
order to construct the world as they
please.
Minecraft’s free-form approach to
gameplay can be quite
challenging, and requires proper
planning, good organization skills,
and the ability to sustain effort and
attention towards a goal.
My Two Sons-Five year Apart Twins
References
http://add.about.com/cs/addthebasics/a/history.htmhttp://www.jo
shweed.com/2010/02/inspirational-quote-for-adhd-sir.html
http://www.rxlist.com/adderall-drug/indications-dosage.htm
http://www.drugs.com/sfx/concerta-side-effects.html
http://www.colorsofplay.com/2012/02/art-therapy-for-childrenwith-adhd-and-anxiety-disorders/
learningworksforkids.com/2013/10/minecraft-executivefunctioning-adhd-how-minecraft-can-help-with-adhd/