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NMSP Exam 3 > CNS Stimulants Dr. Iszard > Flashcards

CNS Stimulants Dr. Iszard Flashcards

1
Q

ADHD stimulant medications 3 types

A
  1. Amphetamine, Dextroamphetamine (Methamphetamine)
  2. Lisdexamfetamine (pro-drug)
  3. Methylphenidate, Dexmethylphenidate
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2
Q

ADHD NON-stimulant medications 3 types

A
  1. Atomoxetine
  2. Guanfacine
  3. Clonidine
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3
Q

Stimulants for ADHD

  1. MOA
  2. Isomers and thier efficiency
A
  1. Block reuptake of NE > DA > 5-HT (non-catacholamine sympathomimetics) + INCREASE RELEASE of NT
  2. Dexa- isomers (D-isomers) more CNS activity
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4
Q

Methylphenidate MOA And how it is different

A

BLOCK reuptake of DA

= not increasing release of anything

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5
Q

General Side effects of Stimulants for ADHD

A
  1. Low apetite + reduced growth
  2. Insomnia
  3. Anxiety, jittery
  4. Irritability, agitation (psychosis, mania, vocal tics with high doses
  5. Higher BP/HR
  6. N,V, Headache
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6
Q

RARE side effects of Stimulants for ADHD

A
  1. Priapism
  2. Seizures (lowers conculsive threshold)
  3. Sudden caridac death, like in cocain (another CNS stimulant) = do history and PE
  4. Stroke MI
  5. Chemical Leukoderma = daytrana patch
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7
Q

5 types of administratons for Stimulants for ADHD

A
  1. Immediate release (IR)
  2. Extended release (ER)
  3. Long Acting (LA)
  4. Controlled delivery (CD)
  5. Oral Disintegrating Tablet (ODT)
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8
Q

RISKS of Stimulants for ADHD

A
  1. CVD due to increased BP
  2. Anxiety
  3. HTN
  4. Glaucoma
  5. Motor tics = like Tourettes
  6. Mania / psychosis = not treated
  7. Seizures
  8. Substance abuse
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9
Q

Stimulants for ADHD IMPORTANT THING for risks and side effects

A

Its VERY patient dependent individually variable with dose and drug and administration type and person

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10
Q

Stimulants for ADHD standard release takes how long for onset
= perscribed how

A
  1. 20min

2. 1 month supply no refills no samples (some allows 3 months) = schedule 2 drug

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11
Q

Immediate release drugs, length and formulations (how its given)**

[AMPHETAMINES]

A

AMPHETAMINE compounds = 4-6hours

  1. Dextroamphetamine (AMP) [adderall] = tablet
  2. Detroamphetamine sulfate [Procentra] = liquid
  3. Amphetamine sulfate = capsule
  4. Dextroamphetamine [Zenzidi] = tablet , lower dose then adderall
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12
Q

Extended Release drugs 5 , average duration, FORMULATIONS (how its given)**

[AMPHETAMINES]

A

8-12 hours

  1. Dextroamphetamine [Adderall XR] = Capsule
  2. Dextroamphetamine [Dexedrine] = Capsule
  3. Amphetamine = Liquid
  4. Lisdexamfetamine = Capsule
  5. Amphetamine mixed salts = Capsule
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13
Q

XR-ODT

A

Extended release Oral dissentigrating tablet = ADZENYS amphetamine
(Put under tongue , dont need water)=

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14
Q

Immediate Release Stimulants for ADHD drugs 3 , formmulation**

[METHYLPHENIDATE]

A

3- 6 hours

  1. Dexmethylphenidate [focalin] = Tablet
  2. Methylphenidate [methylin] = Liquid
  3. Methylphanidate [Ritalin] = Tablet
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15
Q

Sustained Release Stimulants for ADHD drugs 2 , formmulation**

[METHYLPHENIDATE]

A

4-8 hours

  1. Methylphenidate [ritalin-SR] = tablet
  2. Methamphetamine [desoxyn] = tablet
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16
Q

Extended Release Stimulants for ADHD drugs 9, formmulation**

[METHYLPHENIDATE]

A

8-12 hours

  1. Methylphenidate Aptensio XR = Capsule
  2. Methylphenidate HCI/Concentra = Tablet
  3. Methylphenidate ER Comtepla (XR-ODT) = tablet
  4. Methylphenidate transdermal [Daytrana] = Transdermal patch
  5. Dexmethylphenidate HCL = Capsule
  6. Methylphenidate HCL ER / Ritalin LA = capsule
  7. Methylphenidate HCL / Metadate = capsule
  8. Methylphenidate HCL / QuilliChew = chewable tablet
  9. Methylphenidate Quillivant XR = Liquid
17
Q

Non-Stimulant ADHD medications

1. MOA

A
  1. Increase NT transmission
    = Atomoxetine ——> block NE reuptake
    = Clonidine + Guanfacien ——> CNS a2 AGONIST (cortical pyramidal cells promoting PFC funcitonal connectivity)
18
Q

Non-Stimulant ADHD medications

  1. Onset time
  2. Used for who
  3. Schedule
A
  1. 1-4 weeks
  2. Pt intolorant to stimulation effects, parents that dont like to give child stimulant (severe adhd given stimulant will calm down, no as high euphoric effect) USUALLY for child and preadolescents
  3. Schedule 4 drug (refills, and samples to 1 year)
19
Q

Atomoxetine [Strattera]

  1. Type of adm
  2. How its given
  3. Duration
  4. Side effects **
  5. Approved for what age
A
  1. ER
  2. Capsule ** (dont open, dust can irritate eye)
  3. 24hrs
  4. Anxiety, insomnia, dry mouth, LIVER injury, suicidal thoughts possible **
  5. 6 years and older
20
Q

Clonidine [Kapvay]

  1. Type of adm
  2. How its given
  3. Duration
  4. Also called
  5. What should you not do
A
  1. ER
  2. Tablet
  3. 12-24 hours
  4. Anti-hypertenisives (risk of rebound htn if abrupt stop)
  5. Dont open, chew, break
21
Q

Guanfacine [Intuniv]

  1. Type of adm
  2. How its given
  3. Duration
  4. Also called
  5. What should you not do
A
  1. ER
  2. Tablet
  3. 12-24 hours
  4. Anti-hypertenisives (risk of rebound htn if abrupt stop)
  5. Dont open or chew, break tablet
22
Q

How can you clinically manage teh drugs

A

You can give patient short acting (IR) for days they only need to get some things done and drug for long acting (ER) for days they need to get a lot done or all day need to be in control
= minimize time under drug as much as you can

NMSP Exam 3 (13 decks)

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