ADHD Flashcards
amphetamines
release of NE/DA
Diminished fx by DA blockers
increased resorption with alkaline urine, excretion with acidic urine. CYP2D6 metabolism.
atomoxetine
NERI centrally and peripherally. CYP2D6
clonidine
regulation of NE released from Locus ceruleus
no CYP interactions
methylphenidate
DA/NERI
guanfacine
post-synaptic alpha2R agonistic fx on PFC
no CYP interactions
haloperidol
D2 blocker. QT prolongation
4 phases of ADHD therapy
Counseling, titration, maintenance, potential termination
correlation btwn serum drug levels and response in ADHD drugs?
none
Tx of tourette’s & ADHD comorbid
1) alpha2 agonist improve tics & ADHD, 2) stim for adhd only, 3) methylphenidate + alpha2 agonist. Alpha2 agonists only help tics when with ADHD. Otherwise use antipsychotics.
alpha2 agonist examples
clonidine, guanfacine
OD on amphetamines, methylphenidate
sympathetic sx. supportive, give BNZ
atomoxetine toxicity
mild - supportive with sedation, control of dyskinesias & seizures
clonidine OD
paradoxical short-term HTN, then HypoTN. nitroprusside, then pressors.
general stimulant AE & ADEs
CI narrow-angle glaucoma, MAOI, cardiac arrhythmias, liver dzs.
appetite suppression, delayed sleep onset, “wearing off” phenomenon, Tics, depression, social withdrawal
fast, frequent dosing required
