ADHD Flashcards
What are the 3 subtypes of ADHD?
. Combined type with both inattention and hyperactivity symptoms
. Predominantly inattentive
. Predominantly hyperactive/impulsive
Dysregulation of which neurotransmitters are thought to be responsible for clinical manifestations of ADHD?
Dopamine and norepinephrine
Dysregulation of which receptors are thought to be associated with ADHD?
Dopamine D1 receptors
First line treatment options for ADHD
Non-pharm: CBT, psychotherapy, dietary changes, etc.
Which class of drugs is considered first line pharmacotherapy for ADHD?
Stimulants
Stimulant classes
. Amphetamine
. Methylphenidate
Amphetamines have ______ chiral center(s), and have _______ isomers
One, two
In a racemic amphetamine mixture, which isomer is the active compound?
a. d-amphetamine
b. l-amphetamine
a. d-amphetamine
What are the two main pharmacological functions of amphetamines?
. Prevent dopamine reuptake
. Promote dopamine release
Vyvanse (lisdexamphetamine) is composed of what two key compounds?
d-amphetamine covalently bound to L-lysine, metabolized by red blood cells
Methyphenidate has ______ chiral center(s), and has _______ isomers
Two, four
Methylphenidate is an inhibitor of which two CYP enzymes?
. CYP1A
. CYP2E1
What are the two main pharmacological functions of methylphenidate?
. Dopamine reuptake inhibitor
. Weak norepinephrine reuptake inhibitor
Dopamine is responsible for which functions in the mesocortical pathway?
. Verbal fluency
. Serial learning
. Executive function
. Sustaining attention
Norepinephrine is responsible for which functions in the prefrontal pathway?
. Mediating energy/fatigue
. Motivation
. Moderating behavior based on social cues
. Sustaining inattention
Dexmethylphenidate (Focalin) MOA
Norepinephrine-dopamine reuptake inhibitor (NDRI) and releasing agent
Why is the recommended dosage of dexmethylphenidate half or the recommended methylphenidate dose?
Dexmethylphenidate is the isolated active dextro-isomer of the racemic mixture of methylphenidate
Adderall is a mixture of _______ amphetamine salts
Four
Atomoxetine MOA
Selective norepinephrine reuptake inhibitor (NRI)
Clonidine and guanfacine MOA
Alpha-2 adrenergic agonists. Presynaptically inhibit norepinephrine release and post-synaptically increase blood flow to the prefrontal cortex
ADHD symptoms should be present for how long prior to diagnosis?
6 months
How many inattention, hyperactivity or combo symptoms should be present for ADHD diagnosis in ages 16 and under?
6 or more
How many inattention, hyperactivity or combo symptoms should be present for ADHD diagnosis in ages 17 and over?
5 or more
ADHD symptoms must be present in how many settings for diagnosis?
2 or more settings (home, school, work, with freinds, etc.)
Classify the following methylphenidate products as short acting, intermediate acting, or long acting?
a. Ritalin
b. Ritalin LA
c. Concerta
d. Methylphenidate SR
e. Methylin
f. Ritalin SR
g. Metadate CD
h. Metadate ER
i. Methylin ER
a. Ritalin - short acting
b. Ritalin LA - long acting
c. Concerta - long acting
d. Methylphenidate SR - intermediate acting
e. Methylin - short acting
f. Ritalin SR - intermediate acting
g. Metadate CD - long acting
h. Metadate ER - intermediate acting
i. Methylin ER - intermediate acting
Classify the following dextroamphetamine products as short acting, intermediate acting, or long acting?
a. Dexedrine spansule
b. Dextroamphetamine
c. Dexedrine
d. Vyvanse
e. Zenzedi
a. Dexedrine spansule - intermediate acting
b. Dextroamphetamine - short acting
c. Dexedrine - short acting
d. Vyvanse - long acting
e. Zenzedi - short acting
True or false: All capsule formulation may be opened and sprinkled on a small amount of applesauce and taken immediately
False. Vyvanse may not be opened
Daytrana patch should be administered how many hours prior to desired effect?
2 hours
