Pharmacology of ADHD - Martin

Question 1

short acting methylphenidate

Answer 1

ritalin

Question 2

long acting methylphenidate

Answer 2

ritaline LA
concerta
daytrana - patch

Question 3

dexmethylphenidate

Answer 3

d-threo enantiomer of methylphenidate

Question 4

adderall

Answer 4

mixed salt amphetamine - short acting

Question 5

adderall XR

Answer 5

mixed salt amphetamine - long acting

Question 6

atomoxetine

Answer 6

strattera

non-stimulant

Question 7

triad of ADHD

Answer 7

inattentive, hyperactive, impulsive

maladaptive

onset before 12

Question 8

ADHD prevalence

Answer 8

8% school age children

majority adolescents

Question 9

criteria diagnose ADHD

Answer 9

6 or more sx

• inattention
• hyperactivity/impulsivity

onset before 12yo
impair 2 settings
impair social, academic, occupation

Question 10

majority of ADHD

Answer 10

combined type

need to specify - predom inattentive, predom hyperactive/impulse or combined

Question 11

ADHD characters

Answer 11

biologic
not moral disorder
behavioral syndrome
involves biochem messengers - DA, NE, E, etc.

Question 12

methylphenidate

Answer 12

stimulant

Question 13

dextroamphetamine

Answer 13

stimulant

Question 14

lisdexamfetaline

Answer 14

stimulant

oral prodrug - converted to d-amphetamine

longer duration

cannot be crushed and injected

Question 15

stimulant MOA

Answer 15

increased DA
-block reuptake

work to increase DA and NE available

activate inhibitor neurons

Question 16

amphetamines MOA

Answer 16

block DA reuptake

-displace DA and NE - displacing natural storage vesicles

Question 17

atomoxetine MOA

Answer 17

NE reuptake inhibitor

unknown mechanism - increased prefrontal cortex DA

Question 18

methylphenidate NT

Answer 18

increased DA

Question 19

amphetamine NT

Answer 19

increased NE and DA

Question 20

atomoxetine NT

Answer 20

increase NE

Question 21

guanfacine, clonidine MOA

Answer 21

decrease CNS sympathetic outflow

Question 22

goal of stimulant tx

Answer 22

improve concentration

Question 23

adverse stimulants

Answer 23

tics
appetite suppression
anemia
sleep disturbance

Question 24

block DA reuptake

Answer 24

methylphenidate

Question 25

fruit juice

Answer 25

decreased absorption of amphetamines

Question 26

sodium bicarb

Answer 26

increased absorption of amphetamines

Question 27

diversion

Answer 27

selling or giving drugs to others lisdexamfetamine - vyvanse - less abuse, diversion, OD

Question 28

untreated ADHD

Answer 28

more substance abuse tx - significantly decreases risk

Question 29

pt who not respond or can't tolerate stimulant | or refuse controlled substance tx

Answer 29

atomoxetine | strattera

Question 30

clonidine

Answer 30

alpha2 agonist decreased central sympathetic output also in children - sleep problems

Question 31

guanfacine

Answer 31

alpha2 agonist | central acting antiHTN

Question 32

TCAs

Answer 32

not 1st line for ADHD - but efficacious

Question 33

schedule II drugs

Answer 33

dexmethylphenidate methylphenidate dextroamphetamine amphetamine mixed salts

Question 34

high concentration amphetamine

Answer 34

block SERT

Question 35

amphetamine

Answer 35

block DAT and NET

Question 36

IR-MPH

Answer 36

immediate release methylphenidate -short acting within 30 min - peak 1-3 hours DOA 3-5 hours used combo with long duration boost in morning

Question 37

concerta

Answer 37

osmotic release DOA 12 hours methylphenidate

Question 38

daytrana

Answer 38

patch

Question 39

acid urine

Answer 39

more amphetamine excretion

Question 40

DOA dextroamphetamine

Answer 40

starts - 1 hour ingestion DOA 5 hours 2x daily dosing

Question 41

black box atomoxetine

Answer 41

suicide