Chapter 39 - CNS Stimulants and ADHD

Question 1

What do CNS stimulants do?

Answer 1

increase the activity of CNS neurons

Question 2

What is a major AE of all CNS stimulants (in sufficient doses)?

Answer 2

seizures

Question 3

What are CNS stimulants used for?

Answer 3

ADHD and narcolepsy

Question 4

How do amphetamines act?

Answer 4

by releasing DA, NE via inhibiting reuptake in neurons

Question 5

Amphetamines affect which 2 systems?

Answer 5

CNS and CV

Question 6

What aspects of tolerance can develop to amphetamines with regular use?

Answer 6

-elevation of mood
-apetite suppression
-stimulation of heart and blood vessels

Question 7

Do users of amphetamines gain physical dependence?

Answer 7

yes, abstinence syndrome can develop with abrupt withdrawal

Question 8

Why do amphetamines have a high potential for abuse?

Answer 8

euphoric feelings

Question 9

What are the adverse effects of amphetamines?

Answer 9

-CNS stimulation
-weight loss
-CV effects
-psychosis

Question 10

What are the symptoms of acute amphetamine toxicity?

Answer 10

-dizziness
-confusion
-hallucinations
-paranoid delusions
-palpitations
-dysrhythmias
-hypertension
-death (RARE)

Question 11

Fatal overdose via amphetamines can look like:

Answer 11

-convulsions
-coma
-cerebral hemorrhage

Question 12

What is the tx for hallucinations caused by amphetamine toxicity?

Answer 12

chlorpromazine

Question 13

What is the tx for hypertension caused by amphetamine toxicity?

Answer 13

Alpha blocker (phentolamine) or chlorpromazine

Question 14

What is the tx for seizures caused by amphetamine toxicity?

Answer 14

diazepam

Question 15

What is another way to speed up amphetamine excretion?

Answer 15

acidifying urine

Question 16

What is the immediate release form of dextroAMPHETAMINE sulfate called?

Answer 16

Dexedrine

Question 17

What is the extended release form of detroAMPHETAMINE sulfate called?

Answer 17

Dexedrine Spansule

Question 18

What is the brand name of amphetamine/levoamphetamine salts?

Answer 18

adderall XR

Question 19

LisdexAMPHETAMINE is a __________ and is available as tablets or capsules

Answer 19

pro-drug

Question 20

What is methylphenidate?

Answer 20

an amphetamine-like drug used for ADHD and narcolepsy

Question 21

Methylxanthines are derivatives of ___________

Answer 21

xanthine

Question 22

What type of CNS stimulant is caffeine?

Answer 22

a methylxanthine

Question 23

Caffeine is found in…

Answer 23

-chocolate
-soft drinks
-energy drinks
-coffee
-tea

Question 24

How do methylxanthines act?

Answer 24

-reversible blockade of ADENOSINE receptors
-enhancing CALCIUM permeability in sarcoplasmic reticulum
-accumulates cAMP

Question 25

What do methylxanthines do in low doses?

Answer 25

decrease fatigue and increase capacity for prolonged brain power

Question 26

In high doses methylxanthines cause...

Answer 26

-nervousness -insomnia -tremors

Question 27

Large amounts of methylxanthines can cause _____________

Answer 27

seizures

Question 28

Methylxanthines have effects on:

Answer 28

-CNS -heart and vessels -bronchi -kidneys -reproduction

Question 29

Methylxanthines achieve peak plasma levels in _____ hour(S)

Answer 29

1

Question 30

Where are methylxanthines readily absorbed?

Answer 30

GI tract

Question 31

What is another use for methylxanthines besides promoting wakefulness?

Answer 31

neonatal apnea

Question 32

Acute methylxanthine toxicity causes:

Answer 32

-CNS stimulation -tachycardia -respiratory stimulation

Question 33

What is Modafinil used for?

Answer 33

-promoting wakefulness -narcolepsy -shift-work -obstructive sleep apnea -jet lag, MS fatigue (off label)

Question 34

What is the half life of Modafinil?

Answer 34

15 hrs

Question 35

What are the adverse effects of Modafinil?

Answer 35

-headache -nausea -nervousness -increased HR and BP -skin reactions

Question 36

What does Modafinil interact with?

Answer 36

OC's

Question 37

What drugs are used for ADHD in kids?

Answer 37

-methylphenidate -dextroamphetamine -adderall -atomoxetine (non-stimulant_ -A2 agonists -antidepressants

Question 38

How does Atomoxetine act?

Answer 38

selectively inhibits NE reuptake

Question 39

Plasma Atomoxetine levels peak in ______ hour(S)

Answer 39

1-3

Question 40

What are the adverse effects of atomoxetine?

Answer 40

-GI -reduced appetite -dizziness -somnolence -mood swings -insomnia -SUICIDAL IDEATION -caution in CVD