QuestionSBA
QuestionChoice
Fluoxetine is licensed for the treatment of depression in young children. It has no role in treating ADHD alone
34013
d
Fluoxetine 10mg PO OD
QuestionChoice
This is an alternative treatment for ADHD if there is inadequate response to first line treatments
34011
b
Atomoxetine 15mg PO OD
QuestionChoice
This is an alternative treatment for ADHD, but is unlicensed for that indication and is less preferred than first line options
34012
c
Dexamfetamine sulfate 2.5mg PO TDS
QuestionChoice
This is recommended first line to treat ADHD. Lisdexamfetamine mesilate is an alternative first line treatment
34010
a
Methylphenidate hydrochloride 5mg PO OD
QuestionChoice
Risperidone may be used to manage behavioural problems associated with ADHD but would not be initiated as a first line treatment
34014
e
Risperidone 250 micrograms PO OD
QuestionComment
As this patient is a child - and methylphenidate hydrochloride causes growth retardation in children - would it still be recommended to give?
16528
QuestionComment
yes
17336
User
subscriber
JAK Monoclonal
QuestionComment
If in doubt, check the BNFc and that's what it says here! 

42981
User
subscriber
Jaundice Inpatient
User
subscriber
Suture Hematoma
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2746
ADHD in children
Topic
90
Psychiatry
6813
Case Presentation: A 7 year old boy attends a specialist paediatric assessment after being referred via his family GP. He has been reported to have significant difficulty concentrating in school and at home, often disrupting entire class lessons and refusing to sit still for longer than 5 minutes. His mother is now worried about allowing him to play outdoors as he tends towards climbing high objects like trees and fences, and has fallen from them on a number of occasions. His teachers feel that he does exhibit some difficulty in understanding instructions when spoken to, and sometimes makes inappropriate comments in reply to them.


**Investigations**

He has not had any significant developmental delay and has received all his scheduled childhood vaccinations. Baseline ECG normal sinus rhythm. Weight and height on 70th centile for his age and gender. He weighs 30kg.

Question: Select the most appropriate management at this stage.
a