Cognitive Enhancers Flashcards

1
Q

Amphetamines

A
  • Pyschostimulant
  • Immediate release (Dexedrine)
  • Sustaine release (Adderall)
  • Enhances DA release and blocks reuptake (methylphenidate and d-amphetamine)
  • Enhances NE release (d,l-amphetamine i.e. Adderall XR)
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2
Q

Methylphenidate

A
  • Psychostimulant
  • Immediate release (Ritalin)
  • Sustained-release (concerts and metadate CD)
  • Enhances DA release and blocks reuptake
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3
Q

Atomoxetine

A
  • Highly selective NE reuptake inhibitor
  • Elevates DA in prefrontal cortex (but not in nucleus accumbens or striatum)
  • Improves working memory by increase NE
  • ONLY FIRST LINE ADHD MED WITH NO ABUSE POTENTIAL; thus only drug approved to treat adult ADHD
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4
Q

Galanatamine (Razadyne)

A
  • Inhibits AChE
  • Stimulates nicotinic cholinergic neurons to release more stored ACh
  • Can increase risk of stomach ulcers, similar to other cholinesterase inhibitors (use NSAIDS with great caution)
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5
Q

Rivastigmine (Exelon)

A
  • Inhibits both AChE and BuChE
  • Administered twice daily
  • Causes more GI problems and muscle weakness than other cholinesterase inhibitors
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6
Q

Tacrine (Cognex)

A
  • Anti-cholinesterase
  • Short half life
  • Many drug interactions
  • 2nd line therapy for AD
  • May cause liver damage
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7
Q

Memantine

A
  • Useful in patients with moderate to severe AD
  • Antagonist at the NMDA subtype of glutamate
  • Found to help patients in later stages of the disease to maintain additional independence
  • Most common adverse effects of memantine are dizziness, headache, constipation, and confusion
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8
Q

Ginko biloba

A
  • May have modest benefit for AD patients
  • Serious side effects (bleeding, seizures, coma) have been reported with commercial pharmaceutical grade ginkgo biloba preparations
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9
Q

Modafinil (Eugeroic)

A
  • Wakefulness enhancer
  • Questionable mech of action. Increased release of NE and DA, elevates hypothalamic histamine levels
  • Potential abuse in college students
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10
Q

Armodafinl

A
  • Wakefulness enhancer

- Questionable mech of action. Increased release of NE and DA, elevates hypothalamic histamine levels

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11
Q

Why do stimulants work to treat ADHD?

A
  • Areas of the prefrontal and limbic cortex involved with focusing and maintaining attention and prioritizing behaviors are activated by psychostimulants at low (therapeutic) doses
  • Areas of the brain involved in motor activity and arousal get activated at higher (euphoric or toxic) doses
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