ADHD Drugs

Question 1

What is ADHD?

Answer 1

Inattention, Hyperactivity, Impulsivity

Question 2

ADHD Drug therapy Goal (2)?

Answer 2

1) increase attention span
2) improve focus/concentration
- -> DOESN’T TREAT HYPERACTIVITY, or negative behaviors of ADHD

Question 3

ADHD Stimulant Drugs

Answer 3

1st Line Therapy:
Methylphenidate (Concerta, Ritalin)
-brand names based on formulations

Question 4

ADHD Non-Stimulant Drugs

Answer 4

2nd Line Therapy:
-can be used as a monotherapy, but are less effective
-generally used in combination therapy
1) Atomoxetine (Strattera)
2) Alpha-2-adrenergic Agonists
-Guanfacine
-Clonidine
(don't need to know specific names)

Question 5

Methylphenidate (Concerta, Ritalin):

Answer 5

Stimulant ADHD drug
Schedule II
Only effective for 2-3 years

Question 6

Methylphenidate (Concerta, Ritalin) MOA:

Answer 6

Promote NE and Dopamine release, and inhibit their reuptake to increase [drug] at the synaptic cleft to allow for more action.

Question 7

Methylphenidate (Concerta, Ritalin) SEs:

Answer 7

Insomnia, growth suppression causing reduced appetite; HA/Abdominal pain in 10% of pts

Question 8

Methylphenidate (Concerta, Ritalin) Formulations & Administration

Answer 8

SR, IR, & Once-a-day dosing;
Once Daily: early morning dosing preferred
Multiple-dose: don’t take after 4 pm

Question 9

Atomoxetine (Strattera)

Answer 9

Non-stimulant ADHD Drug

NOT a controlled substance (no potential for abuse)

Question 10

Atomoxetine (Strattera) MOA:

Answer 10

Inhibit NE reuptake
Takes 1-3 weeks for a full effect b/c adaptive changes in the brain to increased neurotransmitter at the synaptic must occur first

Question 11

Atomoxetine (Strattera) SEs:

Answer 11

Most common: GI effects &decreased appetite;
CNS effects (dizziness, somnolence, mood swings), insomnia,
RISK FOR SUICIDE IN KIDS!

Question 12

Alpha-2-adrenergic Agonists

Answer 12

2nd Line ADHD Therapy; BP med

Reduces sympathetic NS output from the brain

Question 13

Alpha-2-adrenergic Agonists Considerations

Answer 13

Monitor BP–can cause hypotension!