ADHD drugs

Question 1

amphetamines moa

Answer 1

releases DA and NE

Question 2

Atomoxetine moa

Answer 2

selective NE reuptake inhibitor centrally and peripherally

Question 3

clonidine moa

Answer 3

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

Question 4

guanfacine moa

Answer 4

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

Question 5

haloperidol moa

Answer 5

blocks post synaptic D2 receptors

Question 6

amphetamine interaction with acetazolamide or bicarb

Answer 6

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

Question 7

amphetamine interaction with ammonium chloride

Answer 7

acidic urine favors renal eliminaiton; decreases serum drug levels

Question 8

chlorpromazine, haloperidol interactions with amphetamine

Answer 8

DA receptor blockers diminish effects of amphetamines

Question 9

dextromethorphan effects when used with amphetamine

Answer 9

increased impaired judgement and erratic euphoria

Question 10

effects of digoxin when used with amphetamines

Answer 10

increased pro-arrhythmogenic effect

Question 11

MAOIs when used with amphetamines

Answer 11

increased serum drug levels and toxicity

Question 12

amphetamine, methylphenidate, and atomoxetine metabolism

Answer 12

CYP 2D6 induction or inhibition

Question 13

amphetamine adverse effects

Answer 13

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

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

Question 14

atomoxetine and methylphenidate interactions with albuterol

Answer 14

accentuates CV adverse effects

Question 15

atomoxetine interactions with epinephrine

Answer 15

further increase in BP

Question 16

atomoxetine and methylphenidate interactions with MAOIs

Answer 16

increase toxicity; allow 2 weeks interval between drugs

Question 17

alcohol interactions with methylphenidate

Answer 17

increased production of toxic metabolite; causes functional inability to concentrate

Question 18

phenytoin interactions with methylphenidate

Answer 18

increased blood levels of phenytoin in some patients

Question 19

atomoxetine adverse effects

Answer 19

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

Question 20

methylphenidate adverse effects

Answer 20

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

Question 21

contraindications to stimulant use

Answer 21

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

Question 22

1st line for tourette syndrome

Answer 22

alpha-2 agonist, if comorbid with ADHD

antipsychotics if not comorbid with ADHD

Question 23

clonidine interactions with cyclosporine

Answer 23

increased serum levels of interactant

Question 24

bupropion interactions with guanfacine

Answer 24

grand mal seizures

Question 25

no cyp interactions

Answer 25

guanfacine and clonidine

Question 26

haloperidol metabolism

Answer 26

glucuronidation and CYP 2D6 and 3A4

Question 27

QT prolongation

Answer 27

haloperidol

Question 28

guanfacine and clonidine adverse effects

Answer 28

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

Question 29

clonidine overdose

Answer 29

may cause paradoxical short term HTN, but usually hypotension

Question 30

guanfacine overdose

Answer 30

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

Question 31

amphetamine and methylphenidate overdose

Answer 31

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

Question 32

treatment of amphetamine and methylphenidate overdose

Answer 32

supportive and judicious benzos

Question 33

atomoxetine overdose

Answer 33

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