ADHD Pharm Flashcards
What are the 2 general classes of meds used to treat ADHD
Stimulants
Non-stimulants
What are the following abbreviations:
- IR
- XR
- LA
- CD
- ODT
IR- immediate release XR- extended release LA- long acting CD- controlled delivery ODT- oral disintegrating tablet
MOA of Stimulants
- general
- d-isomers
- amphetamine
- methylphenidate
MOA
Stimulants- inc neurotransmission (sympathomimetics) by blocking reuptake, inc release, and inhibiting VMAT
D-isomers- have more CNS activity
Amphetamine- inc release and inhibit reuptake
Methylphenidate- inhibit reuptake of dopamine/NE
W/ regards to stimulants
- what are the 2 classes
- onset of activity
- FDA classifications
Stimulants
- amphetamines and methylphenidates
- onset w/in 24 hrs
- controlled substances
What are the amphetamine drugs
- amphetamine (d,l)
- dextroamphetamine
- lisdexamphetamine
- mixed salts
Amphetamine (d,l)- adzeny XR-ODT, dyanavel XR, evekeo IR
Dextroamphetamine- dexedrine IR/EX, procentra IR
Lisdexamphetamine- vyvanse (oral chewable prodrug)
Mixed salts- adderall IR/XR, mydayis XR
What are the methylphenidates
- methylphenidate (d,l) (9)
- dexmethylphenidate
Methylphenidate (d,l)- aptenosio XR, ritalin IR/LA, concerta XR, methylin IR, metadate CD, quillivant XR, quillichew XR, daytrana patch, cotempla XR-ODT
Dexmethylphenidate- focalin IR/XR
Adzeny XR-ODT
- what is its class
- what is the % of IR and EX
Adzeny XR-ODT
-amphetamine (d,l)
50% IR 50% EX
Dyanavel EX
- what is its class
- what form does it come in
Dyanavel EX
Amphetamine (d,l)
Liquid
Dexedrine XR
- what is its class
- what form does it come in and how can you take it
Dexedrine XR
- dextroamphetamine
- comes in spansules that you can sprinkle on food
Vyvanse (oral and chewable)
- what is its class
- how is it metabolized and why does it need to be metabolized
- how can it be taken
Vyvanse (oral and chewable)
- lisdexamphetamine
- Prodrug metabolized into dexamphetamine by RBC hydrolytic activity
- Can sprinkle on food or in drink
Adderall XR
- what is its class
- what % is IR and XR
- how can you take it
- who is approved to take it
Adderall XR Mixed salt (amphetamine dl and dextroamphetamine) 50% IR and 50% XR Can sprinkle on food Approved 3 and up
Mydayis
- what is its class
- what % is IR and XR
- how can you take
- who is approved to take it
Mydayis
- mixed salt amphetamine
- 33% IR and 66% XR
- sprinkle on food
- approved 13 and up
Concerta XR
- what is its class
- what is % of IR and XR in phase 1 and 2
Concerta XR
- methylphenidate (d,l)
- phase 1 22% IR and phase 2 is 78% XR
Ritalin LA
- what is its class
- what % is IR and LA
- how can you take
Ritalin LA
- methylphenidate (d,l)
- 50% IR and 50% LA
- sprinkle on food
Metadate CD
- what is its class
- what % is IR and CD
- how can you take
Metadate CD
- methylphenidate (d,l)
- 30% IR and 70% CD
- sprinkle on food
Aptensio XR
- what is its class
- % IR and XR
- how can you take
Aptensio XR
- methylphenidate (d,l)
- 40% IR and 60% XR
- sprinkle on food
Quillichew XR
- what is its class and what makes it unique
- what % is IR and XR
Quillichew XR
- the only XR chewable methylphenidate
- 30% IR and 70% XR
Quillivant XR
- what makes it special and whats its class
- what % is IR and XR
- what do you have to do before taking
Quillivant XR
- only XR suspension methylphenidate
- 20% IR and 80% XR
- shake well before taking
Contempla XR-ODT
- what is its class
- what % is IR and XR
- what must you avoid doing to it
Contempla XR-ODT
- methylphenidate (d,l)
- 25% IR and 75% XR
- DO NOT CHEW OR CRUSH
Focalin XR
- what is its class
- what % is IR and XR
- how can you take
Focalin XR
- dexmethylphenidate
- 50% IR and 50% XR
- sprinkle on food
Stimulants
- AE
- rare AE
Stimulants
AE- NV, HA, dec appetite, insomnia, anxiety, agitation, tics, inc BP/HR
rare AE- seizure, cardiac death (assess for cardiac abnml), chemical leukoderma (daytrana patch)
Non-stimulants
- MOA- for each of the drugs
- onset of activity
- FDA classification
Non-stimulants
- MOA- inc neurotransmission by inhibiting NE reuptake (atomoxetine) or by acting as a2 agonists (guanfacine and clonidine)
- onset w/ in1-4 weeks
- nonscheduled
Atomoxetine
- MOA
- metabolized by what
- what must you avoid doing
- AE- common and rare
Atomoxetine
MOA- NET blocker
metabolized by cyp2d6
Do not open capsules
AE- NV, HA, dec appetite, insomnia, anxiety, agitation, inc BP/HR, BUT DOESN”T CAUSE TICS
rare
Rare AE- suicidal thoughts and liver injury (no seizures)
a2 agonist non-stimulants
- drugs
- what must you avoid doing
- how do you discontinue use
- AE- common and rare
A2 agonist non-stimulants
- drugs- guantacine and clonidine
- do not crush, chew, or break tablets
- downward titrate to discontinue use
- AE- NV, sedation, and dec BP/HR
- rare AE- QT prolongation and AV block