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Pharm Exam 3 > 42: CNS Stimulants and ADHD > Flashcards

42: CNS Stimulants and ADHD Flashcards

1
Q

psychoactive drugs that stimulate the activity of CNS and PNS and temporarily enhance mental or physical functions

A

psychostimulants “uppers”

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2
Q

majority of CNS stimulants are chemically similar to…

A

NE

stimulate the flight or fight system

“sympathomimetics”

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3
Q

what do CNS stimulants increase?

A 
alertness and awakeness
productivity and motivation
arousal, locomotion, HR, BP
euphoria
nervousness and anxiety
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4
Q

what do CNS stimulants decrease?

A

requirements for sleep and food intake

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5
Q

respiratory stimulant used to counteract postanesthetic respiratory depression

A

doxapram

binds to carotid a. chemoreceptors and medullary respiratory centers to increase tidal volume and respiratory rate

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6
Q

clinical use for caffeine

A

primary treatment for apnea of prematurity (breathing cessation in premature infants)

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7
Q

clinical use for theophylline

A

relaxes bronchial smooth muscle –> tx for COPD and asthma

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8
Q

MOA atomoxetine

A

NE reuptake inhibitor

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9
Q

what is the metabolism of CNS stimulants? why is that clinically important?

A

-peripheral degradation by MAOa/b and liver degradation via p450s

** avoid MAOi and SSRI agents (increase levels of drugs)

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10
Q

MOA analeptic stimulants

A

depression of inhibitory neurotransmission

GABAa and glycine antagonist –> decreased chloride influx and hyperpolarization

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11
Q

MOA methylxanthines

A

inhibition of CNS suppressant

reduce adenosine activity by A1 receptor antagonism

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12
Q

MOA amphetamines

A

enhancement of excitatory transmission

increase pre-synaptic release of catecholamines from vesicles/ decreases reuptake

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13
Q

MOA cocaine

A

enhancement of excitatory transmission

  • inhibition of monoamine uptake via blockade of DA and NE and 5HT transporters
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14
Q

clinical use methylphenidate

A

ADHD

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15
Q

narcolepsy treatment

A

modafinil

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16
Q

CNS stimulant used to treat obesity

A

amphetamine

used for appetitie-suppressing properties

17
Q

clinical use orlistat

A

weight loss

lipase inhibitor - decreases fat absorption

GI side effects of steatorrhea, fecal incontinence, flatulence

18
Q

can SSRIs be used for weight loss?

A

weight loss in first 6-12 mo, long term lead to weight gain :(

19
Q

3 legal uses of amphetamine

A

narcolepsy
ADHD
short-term weight loss

20
Q

what area of the brain is associated with reward and affected by cocaine?

A

VTA ventral tegmental area

home of DA neurons

21
Q

MOA cocaine

A

inhibits DAT and increases synaptic DA

22
Q

MOA amphetmaine

A

competitively inhibits DAT and increases synaptic DA

also interferes with VMAT to release DA cytoplasmically and synaptically

23
Q

CNS side effects of psychomotor stimulants

A 
euphoria/dysphoria
insomnia
irritability
tremor
headache 
loss of appetite
24
Q

cardiovascular side effects of CNS stimulants

A

Mi

stroke

25
Q

endocrine side effects of psychomotor stimulants

A

anorexia, severe weight loss

26
Q

ADHD criteria for diagnosis

A

inattention and impulsivity/hyperactivity

six or more from a list present for 6 months for both categories

27
Q

areas of brain most affected by ADHD

A
  • dorsolateral prefrontal cortex
  • dorsal anterior cingulate cortex
  • caudate and putamen
28
Q

dopamine deficit hypothesis of ADHD

A

dorsal lateral prefrontal cortex lacks DA

PFC projects to anterior cingulate cortex –> integration of inattentiveness and regulation of emotions
- supported by Da enhancing treatments

29
Q

FDA approved ADHD treatment with no abuse potential

A

atomoxetine

30
Q

MOA clonidine

A

alpha2 agonist

tx for ADHD - increases blood flow to prefrontal cortex

31
Q

MOA modafinil

A

activates histamine neurons in TMN of hypothalamus (promotes attention and awakeness) – sleep disorders

32
Q

common side effects in ADHD treatment with CNS stimulants

A

decreased appetite and weight loss

insomnia

Pharm Exam 3 (11 decks)

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