AOTA Pharmacology & Medication Management 2 — Questions and Answers
Question 1: A child with sensory processing disorder is prescribed methylphenidate. Which sensory symptom might the OT observe as a side effect requiring documentation?
- Increased proprioceptive seeking
- Heightened tactile defensiveness (Correct answer)
- Reduced vestibular sensitivity
- Improved auditory discrimination
Correct answer: Heightened tactile defensiveness
Stimulant medications like methylphenidate can increase tactile defensiveness in some children, which is a sensory side effect the OT should monitor.
Question 2: An OT notices a client on SSRIs shows increased sensory-seeking behaviors. What is the most appropriate clinical response?
- Immediately discontinue the sensory integration program
- Document the observation and consult with the prescribing physician (Correct answer)
- Increase vestibular input to counteract the drug effect
- Advise the family to reduce the SSRI dosage
Correct answer: Document the observation and consult with the prescribing physician
OTs should document behavioral changes related to medication and consult the prescribing physician rather than independently adjusting medication or treatment.
Question 3: Which class of medications is most associated with decreased arousal levels that may interfere with sensory integration therapy engagement?
- SSRIs
- Stimulants
- Benzodiazepines (Correct answer)
- Beta-blockers
Correct answer: Benzodiazepines
Benzodiazepines cause CNS depression and sedation, which can lower arousal and reduce a child's capacity to engage meaningfully in sensory integration therapy.
Question 4: A parent reports their child just started risperidone. The OT should be aware that this antipsychotic may cause which sensory-related motor side effect?
- Hypersensitivity to light touch
- Extrapyramidal symptoms affecting movement planning (Correct answer)
- Increased auditory sensitivity
- Reduced vestibular nystagmus
Correct answer: Extrapyramidal symptoms affecting movement planning
Risperidone and other antipsychotics can cause extrapyramidal symptoms such as dystonia or akathisia, which directly affect motor planning relevant to OT interventions.
Question 5: In the context of sensory integration, how does guanfacine (Intuniv) differ from stimulant medications in its mechanism relevant to sensory modulation?
- It increases dopamine release in the prefrontal cortex
- It selectively blocks alpha-2 adrenergic receptors
- It reduces norepinephrine activity, calming the arousal system (Correct answer)
- It enhances vestibular receptor sensitivity
Correct answer: It reduces norepinephrine activity, calming the arousal system
Guanfacine is an alpha-2 agonist that reduces norepinephrine activity, which can lower overall arousal and improve sensory modulation in children with ADHD.
Question 6: An OT working with a child on anticonvulsant therapy notices sluggish postural responses. Which anticonvulsant property most directly accounts for this observation?
- Increased sodium channel activity
- GABAergic CNS depression (Correct answer)
- Serotonin reuptake inhibition
- Dopamine receptor blockade
Correct answer: GABAergic CNS depression
Many anticonvulsants enhance GABA activity, producing CNS depression that can slow postural responses and affect sensorimotor performance during OT sessions.
Question 7: When an OT observes that a client's sensory threshold appears significantly lower following a medication change, what is the correct documentation priority?
- Record the change in functional performance and notify the treatment team (Correct answer)
- Immediately suspend all sensory-based interventions
- Request a medication hold from the nursing staff
- Attribute the change to improved neuroplasticity from prior therapy
Correct answer: Record the change in functional performance and notify the treatment team
Accurate documentation of functional changes and interprofessional communication with the treatment team is the OT's primary responsibility when medication effects are suspected.
AOTA Pharmacology & Medication Management 2
A child with sensory processing disorder is prescribed methylphenidate.
Which sensory symptom might the OT observe as a side effect requiring documentation?