ABPN Flashcards

Which medication prevents dopamine from being taken up from the synaptic cleft by blocking dopamine transporters?

Answer: Methlyphenidate

Methylphenidate primarily acts as a dopamine and norepinephrine reuptake inhibitor. It blocks the dopamine transporter (DAT), preventing dopamine from being reabsorbed into the presynaptic neuron. This action increases dopamine levels in the synaptic cleft, making it the correct answer among the choices.

Which medication raises dopamine levels in the synaptic cleft?

Answer: All of the above

Both methylphenidate and amphetamine effectively increase dopamine levels in the synaptic cleft. Methylphenidate primarily achieves this by blocking dopamine reuptake, while amphetamine not only blocks reuptake but also promotes the release of dopamine from presynaptic terminals. Thus, both medications contribute to higher synaptic dopamine.

What effects on the neuroanatomy of norepinephrine neurons do amphetamine and methlyphenidate have in addition to changing dopamine levels?

Answer: Suppress locus coeruleus NE neurons

Stimulants like amphetamine and methylphenidate increase norepinephrine levels in the prefrontal cortex, which is beneficial for ADHD symptoms. However, they also lead to a suppression of the firing rate of norepinephrine neurons in the locus coeruleus (LC), a major source of NE in the brain. This suppression is likely due to increased alpha-2 adrenergic receptor activation and feedback inhibition.

Which of the following qualities of bupropion (Wellbutrin) is NOT TRUE?

Answer: Selective Norepinephrine reuptake inhibitor

Bupropion (Wellbutrin) is primarily classified as a norepinephrine-dopamine reuptake inhibitor (NDRI). While it does inhibit norepinephrine reuptake, its significant action on dopamine reuptake distinguishes it from a selective norepinephrine reuptake inhibitor (SNRI). Therefore, describing it solely as a selective norepinephrine reuptake inhibitor is not entirely accurate.

What Methylphenidate mediation has an osmotic release and lasts for 12 hours?

Answer: Concerta

Concerta is an extended-release formulation of methylphenidate that utilizes an osmotic controlled-release oral delivery system (OROS). This technology allows for a gradual and sustained release of the medication over approximately 12 hours, providing effective symptom control with once-daily dosing. This matches the description of osmotic release and 12-hour duration.

Which of the following does NOT qualify as a typical, targeted side effect of stimulants?

Answer: Ataxia

Common side effects of stimulant medications include changes in mood (e.g., irritability, anxiety), headache, and anorexia (decreased appetite). Ataxia, which refers to impaired coordination or balance, is not a typical or expected side effect of stimulants. Its presence would suggest an unusual or concerning neurological issue.

Clonidine, sometimes known as catapres, is an option for treating ADHD when stimulant medication causes tics to increase.

Answer: True

Clonidine, an alpha-2 adrenergic agonist, is a recognized treatment option for ADHD, particularly when stimulant medications are not tolerated or when co-occurring conditions like tics are present. It can help manage tics and reduce hyperactivity and impulsivity, making it a suitable alternative or adjunct when stimulants exacerbate tics. Therefore, the statement is true.

Which of the following claims regarding childhood ADHD is NOT TRUE?

Answer: Higher doses for inattentive or mixed forms of ADHD, lower doses for hyperactive type

There is no established clinical guideline that dictates higher stimulant doses for inattentive or mixed forms of ADHD and lower doses for the hyperactive type. Dosing of stimulant medication is highly individualized, based on the patient's response, symptom severity, and tolerability, regardless of the specific ADHD presentation type. The goal is always to find the lowest effective dose.

Combining cognitive behavior therapy with selective serotonin reuptake inhibitors (SSRIs) is superior to either treatment alone for treating severe depressive disorder in pediatric patients.

Answer: True

Research, notably the Treatment for Adolescents with Depression Study (TADS), has demonstrated that combining cognitive behavioral therapy (CBT) with selective serotonin reuptake inhibitors (SSRIs) is more effective than either treatment alone for moderate to severe major depressive disorder in pediatric patients. This combined approach often yields superior outcomes. Therefore, the statement is true.

Which of the following SSRIs is NOT highly advised by experts when treating pediatric patients with major depressive disorder?

Answer: Paroxetine

While several SSRIs are used in pediatric depression, paroxetine (Paxil) is generally not highly advised by experts. This is due to concerns about its side effect profile, including a higher risk of discontinuation syndrome and potential for increased suicidality in some studies, compared to other SSRIs like fluoxetine and sertraline, which are often preferred.

Which of these DOES NOT describe an individual with Autism Spectrum Disorders?

Answer: Delusions

Autism Spectrum Disorders (ASD) are characterized by persistent deficits in social communication and interaction, and restricted, repetitive patterns of behavior, interests, or activities. Delusions, which are fixed, false beliefs not amenable to change in light of conflicting evidence, are not a core diagnostic criterion or typical feature of ASD; they are more characteristic of psychotic disorders.