ADHD Flashcards
Brand name formulations of sleep aids in patients using stimulants are _______ for guanfacine ER and _______ for clonidine ER.
Intuniv, Kapvay
Patients who are at a high risk for abusing stimulants or who fail therapy with 2-3 other agents can try ______.
atomoxetine
Stimulant doses can be increased based on response every _____ days.
7
How are stimulants tapered in patients stopping therapy?
no taper hehe gotcha
As CII substances, all stimulants must be dispensed with a _______.
MedGuide
Stimulants are contraindicated within 14 days of the use of a ____________.
MAO inhibitor
Which comorbidities exclude patients from stimulant therapy, or at least warrant additional caution?
cardiac abnormalities (underlying disease, previous MI, heart failure, etc.) anxiety, tension, agitation, glaucoma, hyperthyroidism
What is the concern with stimulant use and the growth trajectory of a child?
Since stimulants cause a decrease in appetite, children may want to eat less and will grow slower.
Ritalin generic
methylphenidate IR tab
methylphenidate patch brand
Daytrana
dexmethylphenidate brand name (tab and ER capsule)
Focalin (XR)
two brand names for ER amphetamine salts
Adderall XR, Mydayis
Vyvanse generic
lisdexamfetamine
Adderall generic
amphetamine salts
Concerta generic
methylphenidate ER (OROS delivery)
Methylin generic
methylphenidate IR oral solution
starting dose of ER methylphenidate
18-36 mg QAM
starting dose of IR methylphenidate
5 mg BID (30 minutes AC)
Quillichew ER is a ______ formulation and Quillivant XR is a ______ formulation of _______.
chewtab, oral suspension, methylphenidate XR
general side effects of stimulants
increased HR and BP, decreased appetite/nausea, irritability, blurry vision, dry mouth
The Daytrana patch should be applied to the _____, put on ____ hours before the desired effect, and worn for no more than ____ hours.
hip, 2, 9
Lisdexamfetamine comes in what two formulations?
capsule, chewtab
How does the formulation of lisdexamfetamine decrease abuse potential?
dextroamfetamine attached to l-lysine that is hydrolyzed in the blood. this takes time, and eliminates the “rush” effect if snorted or injected
Which side effect of stimulants is important to counsel on in male patients?
potential for priapism
If consumed immediately, Vyvanse capsules can be mixed with what three things?
water, yogurt, OJ
Can atomoxetine capsules be opened and sprinkled on food/into liquid? Explain.
No - it’s an irritant
Though rare, toxicity of this organ can occur with atomoxetine, usually within 120 days of starting therapy.
liver
Discontinuation of these two medications used for sleep in ADHD patients should occur with a taper to avoid rebound hypertension.
guanfacine and clonidine
Dose decreases during a clonidine or guanfacine taper should occur every ___ to ___ days.
3 to 7
side effects of atomoxetine
HA, nausea, abd px, insomnia, somnolence, hypertension, tachycardia, dry mouth
The max dose of guanfacine per day is ____ if used with stimulants, ____ if used without.
4, 7
Atomoxetine is a substrate of _______, and should be avoided with strong inhibitors.
CYP2D6
