ADHD- Norepinephrine Reuptake Inhibitors DI Flashcards
NE reuptake inhibitor drugs used in ADHD
Atomoxetine, viloxazine ER
NE reuptake inhibitors are safe and effective in what populations?
Children, teens, adults
NE reuptake inhibitors MoA
Inhibit presynaptic reuptake of NE
Which one has greater efficacy: stimulants or atomoxetine?
Stimulants
How should you dose atomoxetine in children?
BID to increase tolerability
How many times can you dose atomoxetine a day?
1-2 (duration of effect is 10-12 hours)
How many times can you dose viloxazine ER a day?
1 (duration is 24 hours)
Onset of effect of NE reuptake inhibitors
1-2 weeks
Full benefits of NE reuptake inhibitors aren’t seen until when?
6-8 weeks
What may worsen initially with atomoxetine?
Behavior
ADEs of NE reuptake inhibitors
Upset stomach, psychiatric, and CV effects (QTc prolongation)
NE reuptake inhibitors aren’t recommended in what patients?
Patients with structural heart defects or serious heart problems
Risk with long-term use of atomoxetine
Liver toxicity
Which NE reuptake inhibitor needs renal dose adjustment?
Viloxazine ER
Which NE reuptake inhibitor has a BBW and what is it for?
Atomoxetine, has a BBW for new-onset suicidality
NE reuptake inhibitors: both of them have DDIs with these meds
Each other
QTc prolongation with APS, TCAs
Atomoxetine-specific DDIs
Increased concentrations by paroxetine and fluoxetine
Viloxazine is an inhibitor for what CYP enzymes?
strong 1A2, weak 2D6 and 3A4
Viloxazine DDIs: ADs
duloxetine, fluoxetine, paroxetine, venlafaxine, TCAs
Viloxazine DDIs: APS
aripiprazole, asenapine, chlorpromazine, clozapine, olanzapine, perphenazine, risperidone, thioridazine
Viloxazine DDIs: controlled substances
BZDs
Buprenorphine, hydrocodone, methadone, oxycodone
