63 - Pathophysiology of ADHD, Pharmacology of Stimulants (Yang)

Question 1

the ___ activating system (RAS) - very complex, contains DA, adrenergic, serotonergic, and cholinergic neurons
- regulated ___ , sleep-wake, anf sychronization of EEG

Answer 1

reticular
arousal

Question 2

patho of ADHD

genetic vs non-genetic

implicated systems
- ___ transporter, COMT, cholinergic receptors, cholesterol metabolism

enviromental factors

reduced total brainvolume and activity in key areas

Answer 2

dopamine

Question 3

symptoms at ages 5-9 (generally before age ___ )
- significant impairment in ___ or more settings (home vs school)
- interferes with functioning and development

Answer 3

12
2

Question 4

symptoms

inattention
hyperactivity
impulsivity
possivle circuity mechanism: medial prefrontal ___ control might not be fully functional

Answer 4

cortex

Question 5

PCOL of stimulants

methylxanthines - ___ acting sympathomimetics
- mimic effect of endogenous agonists of the sympathtic nervous system

Answer 5

indirect

Question 6

methylxanthines: caffeine, paraxanthine, theobromine, theophyllin

Answer 6

Question 7

PCOL of methyxanthines

antagonize ___ receptors
- inhibit phospodiesterases; increase ___
- increase activitivy of ryanodine receptors; increasing intracellular ___

Answer 7

adenosine
cAMP
Ca

Question 8

PCOL of methyxanthines

(adenosine receptors)
A1 - G _ / _ linked pre and post synaptic; ___ modulation of many neurotransmitters
- CNS activation: ___ , neuroprotection, anxiolysis, ___ activity
- peripheral action: decreased ___ , bronchoconstriction

A2- G __ linked pre and post
- located in ___ and striatum: vasodilation

A2B - G __ linked, mostly on ___ cells; function unknown

A3 - G __ linked, hippocampus and thalamus
- only activated in states of excess ___ e.g. seizures, hypoglycemia, stroke
- not antagonized by ___

Answer 8

i/o, inhibitory
- sedation, anticonvulsant
- HR
- s, vasculature
- s, glial
- q, catabolism, methlyxanthines

Question 9

PCOL of methyxanthines

increased ___
decreased ___

Answer 9

alertness
fatigue

Question 10

PCOL of stimulants

indirect acting
- act on ___ and ___ transporters
- reward pathway - potential for abuse

Answer 10

NET, VMAT

Question 11

PCOL of stimulants

monoamine transporters
- NE
- serotonin
- ___

Answer 11

DA

Question 12

PCOL of stimulants

indirect acting sympathomimetics: cocaine
- inhibit ___ transporters (NE, 5HT, DA)
- used as local ___

blockade only

Answer 12

monoamine
anesthetics

Question 13

PCOL of amphetamines

• non ___ activation of ___
• wakefullness, alertness, increased ability to concentrate
• highly rewarding = abuse potential

Answer 13

selective, monoamines

Question 14

examples of amphetamines

• dextroamphetamine (Dexedrine)
• ___ (Vyvanse)
• ___ (Ritalin)
• ___ (Focalin)
• Adderall = ___ of salts, ___ acting agent
• ___ (mixture of amphetamine salts)

used for narcolepsy, anorexiant, ADHD

Answer 14

• lisdexamfetamine
• methylphenidate
• dexmethylphenidate
• mixture, long
• Mydayis

Question 15

non-stimulants for ADHD

• ___ (Strattera) - ___ reuptake inhibitor
• TCAs
• bupropion
• ___ (Catapres)
• guanfacine
• modafinil (Provigil) - approved for ___ not ADHD

Answer 15

atomoxetine, NET
clonidine
narcolepsy

Question 16

narcolepsy

• excessive ___ sleepiness
• ___ - weakening of muscles
• poor qulaity of sleep
• paralysis
• hallucinations

Answer 16

daytime
cataplexy

Question 17

treatment of narcolepsy

stimulants for sleepiness
___ (Sunosi) - ___ and ___
- treatment of obstructive sleep apnea and narcolepsy excessive sleepiness
- modafinil - ___ (?)
- antidepressants
- GHB - ___
- Pitolisant - ___ receptors antagonist

Answer 17

solriamfetol, NET, DAT
DAT
Xyrem
H3