42: CNS Stimulants and ADHD Flashcards Preview

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Flashcards in 42: CNS Stimulants and ADHD Deck (32):
1

psychoactive drugs that stimulate the activity of CNS and PNS and temporarily enhance mental or physical functions

psychostimulants "uppers"

2

majority of CNS stimulants are chemically similar to...

NE

stimulate the flight or fight system

"sympathomimetics"

3

what do CNS stimulants increase?

alertness and awakeness
productivity and motivation
arousal, locomotion, HR, BP
euphoria
nervousness and anxiety

4

what do CNS stimulants decrease?

requirements for sleep and food intake

5

respiratory stimulant used to counteract postanesthetic respiratory depression

doxapram

binds to carotid a. chemoreceptors and medullary respiratory centers to increase tidal volume and respiratory rate

6

clinical use for caffeine

primary treatment for apnea of prematurity (breathing cessation in premature infants)

7

clinical use for theophylline

relaxes bronchial smooth muscle --> tx for COPD and asthma

8

MOA atomoxetine

NE reuptake inhibitor

9

what is the metabolism of CNS stimulants? why is that clinically important?

-peripheral degradation by MAOa/b and liver degradation via p450s

** avoid MAOi and SSRI agents (increase levels of drugs)

10

MOA analeptic stimulants

depression of inhibitory neurotransmission

(GABAa and glycine antagonist --> decreased chloride influx and hyperpolarization)

11

MOA methylxanthines

inhibition of CNS suppressant

(reduce adenosine activity by A1 receptor antagonism)

12

MOA amphetamines

enhancement of excitatory transmission

(increase pre-synaptic release of catecholamines from vesicles/ decreases reuptake)

13

MOA cocaine

enhancement of excitatory transmission

- inhibition of monoamine uptake via blockade of DA and NE and 5HT transporters

14

clinical use methylphenidate

ADHD

15

narcolepsy treatment

modafinil

16

CNS stimulant used to treat obesity

amphetamine

used for appetitie-suppressing properties

17

clinical use orlistat

weight loss

lipase inhibitor - decreases fat absorption

GI side effects of steatorrhea, fecal incontinence, flatulence

18

can SSRIs be used for weight loss?

weight loss in first 6-12 mo, long term lead to weight gain :(

19

3 legal uses of amphetamine

narcolepsy
ADHD
short-term weight loss

20

what area of the brain is associated with reward and affected by cocaine?

VTA ventral tegmental area

home of DA neurons

21

MOA cocaine

inhibits DAT and increases synaptic DA

22

MOA amphetmaine

competitively inhibits DAT and increases synaptic DA

also interferes with VMAT to release DA cytoplasmically and synaptically

23

CNS side effects of psychomotor stimulants

euphoria/dysphoria
insomnia
irritability
tremor
headache
loss of appetite

24

cardiovascular side effects of CNS stimulants

Mi
stroke

25

endocrine side effects of psychomotor stimulants

anorexia, severe weight loss

26

ADHD criteria for diagnosis

inattention and impulsivity/hyperactivity

six or more from a list present for 6 months for both categories

27

areas of brain most affected by ADHD

-dorsolateral prefrontal cortex
- dorsal anterior cingulate cortex
-caudate and putamen

28

dopamine deficit hypothesis of ADHD

dorsal lateral prefrontal cortex lacks DA

PFC projects to anterior cingulate cortex --> integration of inattentiveness and regulation of emotions
- supported by Da enhancing treatments

29

FDA approved ADHD treatment with no abuse potential

atomoxetine

30

MOA clonidine

alpha2 agonist

tx for ADHD - increases blood flow to prefrontal cortex

31

MOA modafinil

activates histamine neurons in TMN of hypothalamus (promotes attention and awakeness) -- sleep disorders

32

common side effects in ADHD treatment with CNS stimulants

decreased appetite and weight loss
insomnia