Exam
CV
PPP
BP
HR
Wt



Patients Goals of Treatment: Managing projects more effectively. Not feeling behind. Better time management and organization.

ROS
Sleep ok
No chest, palp, No SOB,no claudication, no mania, no depression
Positional hypotension, mild presyncope upon standing 2 times per week. 1 episode syncope many years ago

O/E
HR 60 bpm 105/ 70 mm hg,
CV Normal s1 s2 no murmur, regular rate and rythym, PPPB, no temporal, aortic or renal bruit. AA non palpable
Abdo soft non nontender
Resp: EAB
wt:76.7 kg

ASSESSMENT
Dx ADHD as per psychiatrist assessment
Low risk for side effects no contraindications

PLAN
1. Trial of Vyvanse 10 MG
Follow up in 1 month to assess response
2. Discussed
Contraindication for Psychostimulant Medication
MOA-i- no
treatment of CVD- no
Glaucoma- no
Arteriosclerosis-no
hyperthyroidism screen
allergy to medication-no
Mania or psychosis- denies
Moderate to severe hypertension 160/100 or sign of end organ damage- no
Pheochromocytoma- on

3.Discussed Potential drug interactions
antidepressants
antipsychotics
anticonvulsants
Warfarin

4.Advised on potential Adverse effects
Tics, Sleep disturbance, Stomach pain,headache, reduced appetite, hypertension
5. Signed Medication contract
6. Follow weight on subsequent visit
Contraindication for Psychostimulant Medication
MOA-i
treatment of CVD
Glaucoma
Arteriosclerosis
hyperthyroidism
allergy to medication
Mania or psychosis
Moderate to severe hypertension 160/100 or sign of end organ damage
Pheochromocytoma

Potential drug interactions
antidepressants
antipsychotics
anticonvulsants
Warfarin

resources

http://www.helpforadd.com/2013/june.htm
http://www.helpforadd.com/monitor.pdf
http://adhdinadults.com/category/adhd-treatment/
http://naceonline.com/AdultADHDtoolkit/assessmenttools/wfirs.pdf

https://www.mdcalc.com/adult-self-report-scale-asrs-adhd

https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf