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Flashcards in ADHD Drugs Deck (39):
1

brain area for attentiveness

cingulo-fronto-parietal attention network

2

brain area for mind wondering

default mode network (DMN)

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main NTs of ADHD

DA, NE in prefrontal cortex

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normal attentiveness functioning

auto receptors decrease DA and NE phasic release

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transporters involved in ADHD

vesicular monoamine transporter 2- pumps NT into storage vesicles
DAT
NET

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axon terminal autoreceptors

D2, alpha2

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postsynaptic receptors

D1

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issue in ADHD

increased DAT activity results in less tonic DA to bind to the auto receptors that decrease phasic DA release --> too much DA in the mind wondering area and not enough activation of the CFP area

9

2 major effects of ADHD drugs

increase tonic levels of DA
increase noradrenergic signaling to increase stimulation of post alpha2 receptors

10

amphetamine examples

amphetamine
dextroamphetamine
lisdexamfetamine

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lisdexamfetamine

prodrug to reduce risk of overdose and abuse

12

MOA of amphetamines

DAT inhibition
VMAT2 inhibition
TAAR1 activation

13

TAAR1

activated by amphetamines
phosphorylates DAT which makes it run in reverse to move DA INTO the synapse --> increase tonic action

14

amphetamine side effects

nervous
insomnia
anorexia
abdominal pain
headache
dullness/fatigue
emotional lability
dry mouth
tic worsening
increased BP
growth inhibition
sudden death

15

withdrawal symptoms of amphetamines

dysphoria
sleep disturbances
psychomotor changes
increased appetite

16

signs of supra therapeutic amphetamine dose

supranoramalization
anxiety
dilated pupils
sweating, flushing, pallor
hyperthermia
tremor

17

toxic amphetamine dose

arrhythmia
heart block
circulatory collapse
rhabdomyolysis
seizures
coma
death

18

contraindication to amphetamines

eating disorders
substance abuse
advanced CVD
moderate/severe HTN
structural heart defects
hyperthyroidism
glaucoma
breastfeeding

19

amphetamine interactions

sympathomimetics
antipsychotics (Li)

20

methylphenidate, dexmethylphenidate

stimulants with a shorter duration of action

21

MOA methylphenidate

blocks DAT and NET

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side effects of methylphenidate

nervousness
insomnia
dullness/fatigue
emotional lability
worsening of tics
growth inhibition

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which has more CV issues

amphetamines more than methylphenidate

24

which are scheduled drugs

amphetamines
methylphenidate

25

alpha2 agonist MOA

alpha2 agonist- decreases phasic release

26

guanfacine ADR

sleepiness
hypotension
bradycardia
syncope
fatigue
depression

27

cautions for alpha2 agonists

hypotension
anxiety with abrupt stop

28

interactions for agonists

hypotensive agents
MAOI
cyp metabolism

29

clonidine ADR

nasal congestion and irritation
throat irritation
worse sleepiness and hypotension than guanfacine

30

alpha2 agoinsts

guanfacine
clonidine

31

atamoxetine

non stimulant for ADHD
second line

32

atamoxetine MAO

selective NET inhibition

33

adr atamoxetine in kids

GI upset
increased suicidal thoughts/behaviors

34

adr atamoxetine adults

insomnia
anticholinergic effects
GI upset
sexual effects

35

contraindications of atamoxetine

glaucoma
jaundice

36

interactions of atamoxetine

MAOI
cyp

37

second line drugs for ADHD

antidepressants
anxiolytics
modafinil

38

antidepressants/anxiolytics for ADHD

TCA
bupropion
buspirone

39

modafinil

stimulant for narcolepsy