Misc CNS + ADHD

Question 1

nonpharmacological tx for muscle spasms

Answer 1

heat, massage, TENS unit

Question 2

3 types of pharmacological tx for muscle spasms

Answer 2

1. acetaminophen
2. NSAIDS
3. muscle relaxants

Question 3

muscle relaxants are part of which type of pain management

Answer 3

multimodal :)

Question 4

what is the prototype for muscle relaxants?

Answer 4

cyclobenzaprine (Flexeril, Flexmid)

Question 5

what is the most efficacious drug for muscle spasms?

Answer 5

cyclobenzaprine (Flexeril, Flexmid)

Question 6

what are the SE for cyclobenzaprine?

Answer 6

CNS - drowsy, dizzy, fatigue

Question 7

what substances should be avoided with cyclobenzaprine use?

Answer 7

ETOH, other CNS drugs

Question 8

do CNS effects diminish with use with cyclobenzaprine or remain in tact?

Answer 8

diminish with continued use

Question 9

what is the drug of choice for spasticity (MS, CP)?

Answer 9

baclofen (Lioresal)

Question 10

what is the MOA for baclofen (Lioresal)?

Answer 10

decreases spasms with no muscle weakness

Question 11

SE of baclofen

Answer 11

CNS effects

Question 12

to avoid baclofen OD (respiratory death + coma), what do we need to do?

Answer 12

slowly titrate doses over time… start low and go slow

Question 13

what substances should be avoided with baclofen (Lioresal) tx?

Answer 13

ETOH + other CNS drugs

Question 14

what is the most efficacious drug (stimulant) for ADHD tx?

Answer 14

methylphenidate (Concerta)

Question 15

how long does the efficacy of methylphenidate (Concerta) last? what would happen then?

Answer 15

2-3 years – you would expect to switch over to a non-stimulant ADHD drug (atomexetine - Straterra)

Question 16

with which type of ADHD drug would you see effects QUICKLY?

Answer 16

stimulant ADHD drug - methylphenidate (Concerta)

Question 17

SE of methylphenidate

Answer 17

insomnia, decreased appetite, growth suppression, HA

Question 18

what is the prototype for non-stimulant ADHD tx?

Answer 18

atomoxetine (Straterra)

Question 19

when are non-stimulant ADHD drugs typically used?

Answer 19

when the first line stimulant ADHD drug efficacy has worn off

Question 20

which of the ADHD treatment drugs takes 1-3 weeks for full effect?

Answer 20

non-stimulant (atomoxetine - Straterra)

Question 21

what is the most concerning SE in atomoxetine?

Answer 21

suicidal thinking, especially in kids

Question 22

what are 2 other options for non-stimulant ADHD treatment, often for kiddos?

Answer 22

guanficine + clonidine (BP meds)