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ADHD drugs Flashcards

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1
Q

amphetamines moa

A

releases DA and NE

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2
Q

Atomoxetine moa

A

selective NE reuptake inhibitor centrally and peripherally

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3
Q

clonidine moa

A

believed due to regulation of NE release from locus ceruleus via alpha-2 agonism

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4
Q

guanfacine moa

A

post-synaptic alpha-2-receptor agonist effects in the pre-frontal cortex

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5
Q

haloperidol moa

A

blocks post synaptic D2 receptors

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6
Q

amphetamine interaction with acetazolamide or bicarb

A

alkaline urine favors repute of drug in renal tubules; increases serum drug levels

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7
Q

amphetamine interaction with ammonium chloride

A

acidic urine favors renal eliminaiton; decreases serum drug levels

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8
Q

chlorpromazine, haloperidol interactions with amphetamine

A

DA receptor blockers diminish effects of amphetamines

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9
Q

dextromethorphan effects when used with amphetamine

A

increased impaired judgement and erratic euphoria

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10
Q

effects of digoxin when used with amphetamines

A

increased pro-arrhythmogenic effect

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11
Q

MAOIs when used with amphetamines

A

increased serum drug levels and toxicity

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12
Q

amphetamine, methylphenidate, and atomoxetine metabolism

A

CYP 2D6 induction or inhibition

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13
Q

amphetamine adverse effects

A

common: abdominal pain, headache, insomnia, loss of appetite

less common: anxiety, emotional lability, nervousness, tachycardia, weight loss

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14
Q

atomoxetine and methylphenidate interactions with albuterol

A

accentuates CV adverse effects

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15
Q

atomoxetine interactions with epinephrine

A

further increase in BP

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16
Q

atomoxetine and methylphenidate interactions with MAOIs

A

increase toxicity; allow 2 weeks interval between drugs

17
Q

alcohol interactions with methylphenidate

A

increased production of toxic metabolite; causes functional inability to concentrate

18
Q

phenytoin interactions with methylphenidate

A

increased blood levels of phenytoin in some patients

19
Q

atomoxetine adverse effects

A

dry mouth, headache, abdominal pain, decreased appetite, cough, somnolence, vomiting, insomnia

20
Q

methylphenidate adverse effects

A

headache, insomnia, decreased appetite, n/v, abdominal pain

21
Q

contraindications to stimulant use

A

MAOIs, psychosis, glaucoma, underlying cardiac conditions, existing liver disorders, history of stimulant drug dependence

22
Q

1st line for tourette syndrome

A

alpha-2 agonist, if comorbid with ADHD

antipsychotics if not comorbid with ADHD

23
Q

clonidine interactions with cyclosporine

A

increased serum levels of interactant

24
Q

bupropion interactions with guanfacine

A

grand mal seizures

25
Q

no cyp interactions

A

guanfacine and clonidine

26
Q

haloperidol metabolism

A

glucuronidation and CYP 2D6 and 3A4

27
Q

QT prolongation

A

haloperidol

28
Q

guanfacine and clonidine adverse effects

A

skin reactions (patch), dry mouth, somnolence, headache, fatigue, drowsiness, anxiety, abdominal pain

29
Q

clonidine overdose

A

may cause paradoxical short term HTN, but usually hypotension

30
Q

guanfacine overdose

A

mixed picture -
initial: drowsiness, lethargy, dry mouth, and diaphoresis
CV effects: hypotension or HTN

31
Q

amphetamine and methylphenidate overdose

A

primarily neurological and cardiovascular effects - mydriasis, tremor, agitation, hyperreflexia, combative behavior, confusion, hallucinations, delirium, anxiety, paranoia, movement disorders, and seizures
secondary complications can involve renal, muscle, pulmonary, and GI

32
Q

treatment of amphetamine and methylphenidate overdose

A

supportive and judicious benzos

33
Q

atomoxetine overdose

A

generally mild: drowsiness, agitation, hyperactivity, GI upset, tremor, hyperreflexia, tachycardia, hypertension, and seizure

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