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NMSP Exam 3 > Pharmacology of CNS Stimulants- Iszard > Flashcards

Pharmacology of CNS Stimulants- Iszard Flashcards

1
Q

ADHD medications can be divided into what 2 categories?

A

Stimulants (amphetamine derivatives), Non-Stimulants

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2
Q

what are the stimulant drugs?

A

Amphetamine, Dextroamphetamine, Lisdexameftamine (pro-drug), Methylphenidate

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3
Q

what are the non stimulants ?

A

atomoxetine, guanfacine, clonidine

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4
Q

what enhances neurotransmitter transmission by serving as direct and indirect non-catecholamine sympathomimetics

A

stimulants

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5
Q

stimulants MOA

A

block presynaptic reuptake, and interferes vesicular monoamine transporter (VMAT) and while increases neurotransmitter release.

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6
Q

stimulants increase neurotransmitter release _ then _ then _ at each increasing dose

A

NE

DA

5HT

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7
Q

_ isomers of AMP/MPH more CNS activity than _ or _ isomers

A

D-isomer

L-isomer/Mixed isomers

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8
Q

methylphenidate main activity is to

A

inhibit DA (dopamine) reuptake and neurotransmitter presynaptic reuptake

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9
Q

MPH does or does not stimulate release of neurotransmitters

A

does not

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10
Q

side effects of stimulants

A

dyspepsia, GI distress, decreased appetite (W/L) insomnia, anxiety, irritability, elevated BP/HR

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11
Q

what are the rare side effects of stimulants

A

Priapism (painful and prolonged errection of the penis)

lowering of the convulsion threshold leading to increased susceptibility to seizures

sudden cardiac death

stroke, MI

chemical leukoderma with daytrana patch

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12
Q

always assess for cardiac structural abnormalities in someone taking _ drugs for ADHD

A

stimulants

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13
Q

what is chemical leukoderma w/ daytrana patch?

A

hypopigmentation of the skin associated with the daytrana patch ( stimulant in patch form)

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14
Q

formulation abbreviation for immediate release

A

IR

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15
Q

formulation abbreviation for extended release

A

ER and XR

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16
Q

formulation abbreviation for long acting

A

LA

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17
Q

formulation abbreviation for controlled delivery

A

CD

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18
Q

formulation abbreviation for oral disintegrating tablet

A

ODT

19
Q

in what situations should caution you in using stimulants

A

anxiety, agitation, symptomatic CV disease, moderate to severe HTN, glaucoma, motor tics, poorly-controlled seizures, abuse disorder

20
Q

stimulant onset of activity is usually in _ minutes in most patients

A

20

21
Q

stimulants are _ substances, MO does allow future dating

A

controlled

22
Q

guidelines for the use of ADHD drugs

A

over the age of 6 is considered reasonable for medication to be a first line treatment- stimulants

23
Q

dextrotoamphetamine/AMP/Adderall is given in _ form (IR)

A

TAB

24
Q

dextroamphetamine sulfate/procentra is given in _ form (IR)

A

LIQ

25
Q

amphetamine sulfate is given in _ form (IR)

A

CAP

26
Q

dextroamphetamine/zenzidi is given in _ form (IR)

A

TAB

27
Q

immediate release stimulants on average have a duration of?

A

4-6 hours

28
Q

dextroamphetamin/adderall is given in _ form (ER)

A

CAP

29
Q

dextroamphetimine/dexedrine is give in _ form (ER)

A

CAP

30
Q

amphetamine/dyanaval is given in _ form (ER/XR)

A

Liquid

31
Q

Lisedexamfetamine/vyvanse is given in _ form (ER)

A

CAP

32
Q

amphetamine (mixed salts)/mydayis is given in _ form

A

CAP

33
Q

dextroamphetamine/adderrall side effects

A

headache, insomnia, decreased appetite, new psychotic problems

34
Q

dextroamphetamine sulfate side effects

A

nervousness, dizziness, constipation, increased TICS, stroke, MI

35
Q

amphetime sulfate side effects

A

new or worse bipolar illness, aggressive behavior

36
Q

dextroamphetamine/zenzidi side effects

A

runny nose, dry mouth

37
Q

MOA of atomoxetine

A

inhibition of NE pre-synaptic reuptake

38
Q

Guanfacine and clonidine MOA

A

agonists of CNS a2 adrenergic receptors

modulates NE tone in the PFC
stimulation of adrenergic receptors in the PFC networks

39
Q

onset of activity for non stimulants

A

1-4 weeks

40
Q

when would we use non stimulants in ADHD

A

if patients are intolerant of stimulant effects or resistant to stimulant class

non-scheduled!

41
Q

Atomoxetine

duration:

form:

adverse effects:

A

duration: 24 hrs

form: CAP

AE: suicidal thoughts

42
Q

clonidine and guanifacine

duration:

form:

AE:

A

duration: 12-24 hrs

form: TAB

SE: anxiety, irritability, decreased appetites, fatigue/drowsiness

43
Q

atomoxitine; do not open capsules do to _ irritant

metabolized by?

A

ocular irritant

CYP2D6

44
Q

discontinued use of guandacine and clonidine has a risk of?

A

rebound hypertension

both are anti-hypertensives

NMSP Exam 3 (11 decks)

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