ADHD

Question 1

Brand name formulations of sleep aids in patients using stimulants are _______ for guanfacine ER and _______ for clonidine ER.

Answer 1

Intuniv, Kapvay

Question 2

Patients who are at a high risk for abusing stimulants or who fail therapy with 2-3 other agents can try ______.

Answer 2

atomoxetine

Question 3

Stimulant doses can be increased based on response every _____ days.

Answer 3

7

Question 4

How are stimulants tapered in patients stopping therapy?

Answer 4

no taper hehe gotcha

Question 5

As CII substances, all stimulants must be dispensed with a _______.

Answer 5

MedGuide

Question 6

Stimulants are contraindicated within 14 days of the use of a ____________.

Answer 6

MAO inhibitor

Question 7

Which comorbidities exclude patients from stimulant therapy, or at least warrant additional caution?

Answer 7

cardiac abnormalities (underlying disease, previous MI, heart failure, etc.)
anxiety, tension, agitation, glaucoma, hyperthyroidism

Question 8

What is the concern with stimulant use and the growth trajectory of a child?

Answer 8

Since stimulants cause a decrease in appetite, children may want to eat less and will grow slower.

Question 9

Ritalin generic

Answer 9

methylphenidate IR tab

Question 10

methylphenidate patch brand

Answer 10

Daytrana

Question 11

dexmethylphenidate brand name (tab and ER capsule)

Answer 11

Focalin (XR)

Question 12

two brand names for ER amphetamine salts

Answer 12

Adderall XR, Mydayis

Question 13

Vyvanse generic

Answer 13

lisdexamfetamine

Question 14

Adderall generic

Answer 14

amphetamine salts

Question 15

Concerta generic

Answer 15

methylphenidate ER (OROS delivery)

Question 16

Methylin generic

Answer 16

methylphenidate IR oral solution

Question 17

starting dose of ER methylphenidate

Answer 17

18-36 mg QAM

Question 18

starting dose of IR methylphenidate

Answer 18

5 mg BID (30 minutes AC)

Question 19

Quillichew ER is a ______ formulation and Quillivant XR is a ______ formulation of _______.

Answer 19

chewtab, oral suspension, methylphenidate XR

Question 20

general side effects of stimulants

Answer 20

increased HR and BP, decreased appetite/nausea, irritability, blurry vision, dry mouth

Question 21

The Daytrana patch should be applied to the _____, put on ____ hours before the desired effect, and worn for no more than ____ hours.

Answer 21

hip, 2, 9

Question 22

Lisdexamfetamine comes in what two formulations?

Answer 22

capsule, chewtab

Question 23

How does the formulation of lisdexamfetamine decrease abuse potential?

Answer 23

dextroamfetamine attached to l-lysine that is hydrolyzed in the blood. this takes time, and eliminates the “rush” effect if snorted or injected

Question 24

Which side effect of stimulants is important to counsel on in male patients?

Answer 24

potential for priapism

Question 25

If consumed immediately, Vyvanse capsules can be mixed with what three things?

Answer 25

water, yogurt, OJ

Question 26

Can atomoxetine capsules be opened and sprinkled on food/into liquid? Explain.

Answer 26

No - it’s an irritant

Question 27

Though rare, toxicity of this organ can occur with atomoxetine, usually within 120 days of starting therapy.

Answer 27

liver

Question 28

Discontinuation of these two medications used for sleep in ADHD patients should occur with a taper to avoid rebound hypertension.

Answer 28

guanfacine and clonidine

Question 29

Dose decreases during a clonidine or guanfacine taper should occur every ___ to ___ days.

Answer 29

3 to 7

Question 30

side effects of atomoxetine

Answer 30

HA, nausea, abd px, insomnia, somnolence, hypertension, tachycardia, dry mouth

Question 31

The max dose of guanfacine per day is ____ if used with stimulants, ____ if used without.

Answer 31

4, 7

Question 32

Atomoxetine is a substrate of _______, and should be avoided with strong inhibitors.

Answer 32

CYP2D6