ADHD Flashcards

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1
Q

CNS Stimulants

A

Most effective. Diminish after 2-3 years. Controlled substances
IND: ADHD
MOA: Stimulate release of NE and Dopamine, block reuptake, stimulates the cerebral cortex. Increase alertness and confidence. Long term; physical dependence.
BOX: Abuse and dependence, high potential
CON:
ADR: Insomnia. Loss of appetite/weight loss especially in pediatrics so counsel parents for a big breakfast. Hypertension/tachycardia. Psychosis

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2
Q

Dextroamphetamine

A

IND: ADHD
MOA: Enantiomer of CNS stimulant. 3:1 dextro:levo
BOX: Sudden death from CV events
CON: Arteriosclerosis, CV dz, HTN, hyperthyroidism, glaucoma, agitation, Hx of drug abuse, use with MAOIs
ADR: HTN, tachycardia, palpitations, appetite suppression, insomnia

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3
Q

Lisdexamfetamine

A

IND: ADHD, binge eating
MOA: CNS stimulant. Prodrug of dextroamphetamine with L-lysine. Lower abuse potential
BOX: n/a
CON: MAOIs
ADR: HTN, tachycardia, Appetite suppression

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4
Q

Methylphenidate

A

IND: ADHD, narcolepsy
MOA: CNS Stimulant. 50/50 dexmethylphenidate and levo
BOX:
CON: MAOIs, anxiety, tension, agitation, Tourette’s
ADR: LESS CV risk. Insomnia and weight loss still present
Patch type available for pts who need it

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5
Q

Dexmethylphenidate

A
IND: ADHD
MOA: CNS stimulant. More potent
BOX:
CON: MAOIs
ADR: Insomnia, jitters, Appetite suppression
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6
Q

Serdexmethylphenidate/Dexmethylphenidate

A

IND: ADHD
MOA: CNS Stimulant 30:70. “Ser” is the prodrug
BOX:
CON: MAOIs
ADR: Insomnia, jitters, appetite suppression

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7
Q

Non-stimulants

A

Less effective
Monotherapy or adjunct
NOT controlled substances

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8
Q

Atomoxetine

A

IND: ADHD
MOA: Selectively inhibits reuptake of NE. Initial response takes 1-3 days, peak at 1-3 weeks
BOX: Suicidal ideation in kids/YA
CON: MAOIs, NAG, CV dz, or Pheochromocytoma
ADR: HA, insomnia, GI/appetite suppression, hyperhydrosis

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9
Q

Viloxazine

A
IND: ADHD
MOA: Inhibits reuptake of NE. 1-3 days, 1-3 weeks
BOX: Suicidal ideation in kids/YA
CON: MAOIs, CYP substrates
ADR: HTN/tachycardia, drowsy
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10
Q

Guanfacine

A

IND: ADHD, autism, HTN, Tics
MOA: Alpha 2 adrenoreceptor agonist. CNS; improves prefrontal cortex neurons (memory and behavior)
PNS; reduce sympathetic nerve impulses = decreased vasomotor tone and heart rate
BOX:
CON:
ADR: Drowsy, HA, fatigue. App suppression, ab pain. Hypotension

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11
Q

Clonidine

A
IND: ADHD, HTN, menopause
MOA: Alpha 2a adrenoreceptor agonist
BOX: 
CON: 
ADR: Hypotension
Comes as patches for HTN treatment
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