Pharmacology of CNS Stimulants- Iszard

Question 1

ADHD medications can be divided into what 2 categories?

Answer 1

Stimulants (amphetamine derivatives), Non-Stimulants

Question 2

what are the stimulant drugs?

Answer 2

Amphetamine, Dextroamphetamine, Lisdexameftamine (pro-drug), Methylphenidate

Question 3

what are the non stimulants ?

Answer 3

atomoxetine, guanfacine, clonidine

Question 4

what enhances neurotransmitter transmission by serving as direct and indirect non-catecholamine sympathomimetics

Answer 4

stimulants

Question 5

stimulants MOA

Answer 5

block presynaptic reuptake, and interferes vesicular monoamine transporter (VMAT) and while increases neurotransmitter release.

Question 6

stimulants increase neurotransmitter release _ then _ then _ at each increasing dose

Answer 6

NE

DA

5HT

Question 7

_ isomers of AMP/MPH more CNS activity than _ or _ isomers

Answer 7

D-isomer

L-isomer/Mixed isomers

Question 8

methylphenidate main activity is to

Answer 8

inhibit DA (dopamine) reuptake and neurotransmitter presynaptic reuptake

Question 9

MPH does or does not stimulate release of neurotransmitters

Answer 9

does not

Question 10

side effects of stimulants

Answer 10

dyspepsia, GI distress, decreased appetite (W/L) insomnia, anxiety, irritability, elevated BP/HR

Question 11

what are the rare side effects of stimulants

Answer 11

Priapism (painful and prolonged errection of the penis)

lowering of the convulsion threshold leading to increased susceptibility to seizures

sudden cardiac death

stroke, MI

chemical leukoderma with daytrana patch

Question 12

always assess for cardiac structural abnormalities in someone taking _ drugs for ADHD

Answer 12

stimulants

Question 13

what is chemical leukoderma w/ daytrana patch?

Answer 13

hypopigmentation of the skin associated with the daytrana patch ( stimulant in patch form)

Question 14

formulation abbreviation for immediate release

Answer 14

IR

Question 15

formulation abbreviation for extended release

Answer 15

ER and XR

Question 16

formulation abbreviation for long acting

Answer 16

LA

Question 17

formulation abbreviation for controlled delivery

Answer 17

CD

Question 18

formulation abbreviation for oral disintegrating tablet

Answer 18

ODT

Question 19

in what situations should caution you in using stimulants

Answer 19

anxiety, agitation, symptomatic CV disease, moderate to severe HTN, glaucoma, motor tics, poorly-controlled seizures, abuse disorder

Question 20

stimulant onset of activity is usually in _ minutes in most patients

Answer 20

20

Question 21

stimulants are _ substances, MO does allow future dating

Answer 21

controlled

Question 22

guidelines for the use of ADHD drugs

Answer 22

over the age of 6 is considered reasonable for medication to be a first line treatment- stimulants

Question 23

dextrotoamphetamine/AMP/Adderall is given in _ form (IR)

Answer 23

TAB

Question 24

dextroamphetamine sulfate/procentra is given in _ form (IR)

Answer 24

LIQ

Question 25

amphetamine sulfate is given in _ form (IR)

Answer 25

CAP

Question 26

dextroamphetamine/zenzidi is given in _ form (IR)

Answer 26

TAB

Question 27

immediate release stimulants on average have a duration of?

Answer 27

4-6 hours

Question 28

dextroamphetamin/adderall is given in _ form (ER)

Answer 28

CAP

Question 29

dextroamphetimine/dexedrine is give in _ form (ER)

Answer 29

CAP

Question 30

amphetamine/dyanaval is given in _ form (ER/XR)

Answer 30

Liquid

Question 31

Lisedexamfetamine/vyvanse is given in _ form (ER)

Answer 31

CAP

Question 32

amphetamine (mixed salts)/mydayis is given in _ form

Answer 32

CAP

Question 33

dextroamphetamine/adderrall side effects

Answer 33

headache, insomnia, decreased appetite, new psychotic problems

Question 34

dextroamphetamine sulfate side effects

Answer 34

nervousness, dizziness, constipation, increased TICS, stroke, MI

Question 35

amphetime sulfate side effects

Answer 35

new or worse bipolar illness, aggressive behavior

Question 36

dextroamphetamine/zenzidi side effects

Answer 36

runny nose, dry mouth

Question 37

MOA of atomoxetine

Answer 37

inhibition of NE pre-synaptic reuptake

Question 38

Guanfacine and clonidine MOA

Answer 38

agonists of CNS a2 adrenergic receptors modulates NE tone in the PFC stimulation of adrenergic receptors in the PFC networks

Question 39

onset of activity for non stimulants

Answer 39

1-4 weeks

Question 40

when would we use non stimulants in ADHD

Answer 40

if patients are intolerant of stimulant effects or resistant to stimulant class non-scheduled!

Question 41

Atomoxetine duration: form: adverse effects:

Answer 41

duration: 24 hrs form: CAP AE: suicidal thoughts

Question 42

clonidine and guanifacine duration: form: AE:

Answer 42

duration: 12-24 hrs form: TAB SE: anxiety, irritability, decreased appetites, fatigue/drowsiness

Question 43

atomoxitine; do not open capsules do to _ irritant metabolized by?

Answer 43

ocular irritant CYP2D6

Question 44

discontinued use of guandacine and clonidine has a risk of?

Answer 44

rebound hypertension both are anti-hypertensives