Werkingsmechanisme lokale corticosteroiden

Abstract Stijntjes F, Hassink-Franke L, Kruishoop A, Beeres MPJ, Eekhof H, Van Manen S, Stoffelsen R, Wensing CL, Fliers EA, Van der Zalm M, Wiersma Tj, Verduijn MM, Burgers JS, De Vries L, Van Avendonk MJP. Dutch College of General Practitioners’ guideline ADHD in children. Huisarts Wet 2014;57(11):584-94. The Dutch College of General Practitioners’ (NHG) Guideline ADHD in children provides recommendations about the recognition, diagnosis, and treatment of ADHD in children and adolescents (< 18 years) in general practice. The diagnosis ADHD is based on a combination of the behavioural characteristics of inattention and hyperactivity/impulsivity. Several of these characteristics have to be present before the age of 12 and in two or more settings (at home, school, club). There has to be clear evidence that the behaviour adversely influences social and academic functioning. Information from the child’s medical record, parents, school, and youth health organizations provides insight into the possible causes of the child’s behaviour, such as: a) suspicion of ADHD, b) psychological or social circumstances, c) somatic problems, d) psychiatric disease, or e) a combination of these possibilities. If there is problem behaviour with only mild dysfunctioning, further diagnostic investigations are unnecessary and the GP should give the parents information and, if relevant, advise them to follow an educational programme. If the GP suspects ADHD with clear dysfunctioning, further diagnostic investigations are required. These can be done by the GP if he has sufficient knowledge and expertise in this area and collaborates with other professionals; otherwise the child should be referred to a psychologist or a specialist in children with special educational needs. If the child appears to meet the criteria for ADHD, the parents and teachers should be provided with information and support and the child should be given behavioural therapy, if appropriate. If there is insufficient improvement, the prescription of methylphenidate can be considered. The effects of treatment should be monitored, and in the case of treatment with methylphenidate additional monitoring of blood pressure, heart rate, height, and weight is recommended every 6 months. If ADHD is diagnosed in combination with psychiatric comorbidity or severe dysfunctioning or if ADHD is diagnosed in a child younger than 6 years, the child should be referred to a child psychiatrist for treatment and follow-up.

Werkingsmechanisme lokale corticosteroiden

werkingsmechanisme lokale corticosteroiden

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