EXAM #3: CNS STIMULANTS Flashcards Preview

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Flashcards in EXAM #3: CNS STIMULANTS Deck (38):
1

What endogenous molecule are most CNS stimulants chemically similar to?

NE

2

What will CNS stimulants increase?

1) Alterness
2) Productivity/ motivation
3) Arousal
4) Euphoria
5) Nervousness and anxiety

3

What will CNS stimulants decrease?

Requirements for:
1) Sleep
2) Food intake

4

What can overdose on CNS stimulants lead to?

- Convulsions
- Death

5

What is an Analeptic?

Respiratory stimulants used to reverse drug-induced CNS depression (esp. post-op)

6

What is the hallmark analeptic?

Doxapram

7

What is the clinical utility of Doxapram?

This is a stimulant used to counteract anesthesia induced respiratory depression

8

What is the MOA of doxapram?

Binds to carotid artery chemoreceptors/ medullary respiratory centers

9

What is the common MOA of the non-doxapram analeptics?

GABA-A antagonists

10

What is a methylxanthine?

Xanthine derivative CNS/ respiratory stimulant

11

List the Methylxanthines.

Caffeine
Theophylline

12

What is the primary clinical indication for caffeine?

Apnea of prematurity

13

What is the clinical indication for Theophylline?

COPD/Asthma

*Drug has bronchodilator properties

14

List the Sympathomimetic Amide stimulants.

Amphetamine analogs:
- Methamphetamine
- Dexamphetamine
- Methylphenidate

Cocaine
Modafinil
Atomoxetine

15

How are the amide psychomotor stimulants metabolized?

1) Monamine oxidase
2) Liver p450

16

What classes of drugs will have adverse drug-drug interactions with the psychomotor stimulants?

MAOI
SSRI

17

What is the duration of action of many psychomotor stimulants? What are the clinical implications?

- Short duration
- Multiple dosing or extended release formulas

18

What is the clinical indication for Modafinil?

Narcolepsy/ sleep disorders

19

What drug is primarily used to treat ADHD?

Methylphenidate (Ritalin)

20

What drug was historically used for weight loss?

Amphetamine

21

How is the drug Orlistat used clinically?

Weight loss

22

What is the MOA of Orlistat?

Lipase inhibitor that decreases GI fat absorption

23

What are the three approved clinical uses for amphetamine?

1) Narcolepsy
2) ADHD
3) Short-term weight loss

24

What risk potential does cocaine have? Why?

Level 5 i.e. highest b/c it stimulates VTA reward pathway

25

What is the MOA of cocaine?

Inhibits DAT i.e. prevents DA reuptake

26

What is the MOA of amphetamine?

1) Taken up into pre-synaptic vesicle by DAT (prevent DA reuptake)
2) Binds/ inhibits VMAT to cause DA release

27

Aside from DAT, what other transporters do cocaine and amphetamine have effects on?

SERT
NET

28

What are the common CNS related side effects of the psychomotor stimulants?

Euphoria
Dysphoria
Insomnia
Irritability
Tremor
Headache
Anorexia

29

What are the cardiovascular related side effects of the psychomotor stimulants?

MI
CVA

30

What percentage of ADHD patients are the predominant hyperactive/impulse subtype?

10%

31

What percentage of ADHD patients are the predominant inattentive subtype?

30-40%

32

What percentage of ADHD patients are the combined subtype?

50-60%

33

What are the symptoms of ADHD that are common in children with the disorder?

1) Motor hyperactivity
2) Aggressive
3) Low frustration tolerance
4) Impulsive

34

Why are psychomotor stimulants given in ADHD?

Dopamine Deficit Hypothesis of ADHD--esp. in the PFC

35

What drugs are used to treat ADHD?

Methylphenidate
Amphetamine salts
- Addreall/ Adderall XR
Dextroamphetamine

36

What are the non-stimulant drugs that are given for ADHD?

1) Atomoxetine (NE-reuptake blockade)
2) Clonidine (alpha-2 agonist-->increase blood flow to PFC)
3) Modafinil (Activates histamine)
Antidepressants
- TCA
- MAOI
- Bupropion

37

Can Modafinil be used in children? Why or why not?

NO--Rash?

38

What are the major side effects of ADHD treatment?

- Decreased appetite/ weight loss
- Insomnia

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