ADHD Pharm

Question 1

2 families of drugs for ADHD?

Answer 1

Stimulants and non stimulants

Question 2

MOA of stimulants?

Answer 2

Enhance NT transmission by blocking reuptake, blocking VMAT, and increasing NT release

Question 3

Which isomer of methylphenidate and amphetamine has more CNS activity?

Methylphenidate 2 main activities and what 1 activity does it not really do?

Answer 3

D

Inhibition of DA reuptake and inhibition of NT presynaptic uptake
Doesn’t really stimulate release of NT release

Question 4

5 side effects to stimulants?

Answer 4

Gi problems, HA, decreased appetite, insomnia, anxiety

Question 5

5 rare side effects to stimulants?

Answer 5

Priapism, seizures, cardiac death, stroke and MI, chemical leukoderma

Question 6

What to always assess for in patients you will be prescribing a stimulant?

Answer 6

Heart

Question 7

Onset of activity for stimulants is how long?

Stimulants are what kind of substances?

Answer 7

24 hours

Controlled so 1 month supply, some states let you do 3 months

Question 8

What is adzenys XR ODT?
What is the ratio?
What does XR ODT mean?
Approved for what ages?

Answer 8

D,l amphetamine
3:1 ratio of d and l
50% IR 50%XR
6 and older

Question 9

MOA of non stimulants and the 2 effects because of it?

Answer 9

Enhance NT release by inhibitors NE presynpatic uptake
Agonist of CNA alpha 2 adrenergic recptors

1. Modulates NE tone in PFC by enhancing NE input from LC
2. Stimulating postsynaptic stimulation of alpha 2 receptors on pyramidal cells to promote PFC functionality

Question 10

MOA of atomoxetine?

Answer 10

Inhibit NE pre synaptic reuptake

Question 11

MOA of guanfacine and clonidine?

Answer 11

Alpha 2 agonist

Question 12

Onset of activity of non stimulants?
Useful for what type of patients?
What schedule are these guys?

Answer 12

1-4 weeks
Don’t tolerate stims very well or parents who don’t want kids on it
Non scheduled so can get up to a year at a time

Question 13

What is the form of atomoxetine and what are you not supposed to do with it and why?
What age group?

Answer 13

Capsule
Don’t open capsule because of ocular irritant
6 and up

Question 14

What form is clonidine and guanfacine?
Do not what with these meds?
Age group?
How to discontinue and why?

Answer 14

Extended release tablets
Crush, chew or break
6 and up
Titrations over a week or two because of risk for rebound HTN