ADHD Pharm (Segars)

Question 1

which isomers of amphetamine/methylphenidate have greater CNS activity?

Answer 1

D > Mixed or L

Question 2

Methylphenidates main activity as a stimulant?

Answer 2

inhibition of DA reuptake and inhibition of NT pre-synaptic reuptake…doesn’t appear to stimulate release of NTs

Question 3

Adzenys XR-ODT, Dyanavel XR (oral susp), and Evekeo (IR) are what type of stimulant?

Answer 3

Amphetamine (d,l)

Question 4

Dexedrine (IR and XR) and ProCentra (IR oral) are what type of stimulant?

Answer 4

Dextroamphetamine

Question 5

Vyvanse is a pro-drug of what and what type of stimulant?

Answer 5

pro-drug of dextroamphetamine

Lisdexamfetamine

Question 6

Adderall (IR), Adderall (XR) are what type of stimulant?

Answer 6

Mixed amphetamine salts –> Amphetamine and Dextroamphetamine

Question 7

Aptensio XR, Ritaline (IR), Ritalin LA, Concerta, Methylin (IR oral and IR chewable), Metadate CD, Quillivant XR (Oral), QUillichew ER (Chewable), and Daytrana (patch) are what types of stimulant?

Answer 7

Methylphenidate (d,l)

Question 8

Focalin (IR) and Focalin XR are what type of stimulant?

Answer 8

Dexmethylphenidate

Question 9

Stimulant onsent of activity usually __ hrs in most pts. Stimulants are __ substances (1 month supply only, no refills, no samples) but some states allow 3 months of Rx
BIG STAR

Answer 9

24

controlled

Question 10

This amphetamine formulation is a Non-IR form, 3:1 d-amphetamine: l-amphetamine isomer, 50% IR and 50% XR, QD dosing, and is an ODT

Answer 10

Adzenys XR-ODT (d,l amphetamine)

Question 11

This amphematine formulation is a Non-IR form, Liquid, 3.2:1 d-amphetamine: l-amphetamine isomer, QD dosing

Answer 11

Dyanavel XR liquid (D,l)

Question 12

This dextroamphetamine formulation is Non-IR form, can sprinkle on food, also approved for narcolepsy in adutls, and QD dosing

Answer 12

Dexedrine spansules (Dextroamphetamine)

Question 13

This amphetamine formulation is a pro-drug of dextroamphetamine, converted to dextroamphetamine by hydrolytic activity of RBCs, can be emptied into water, juice, yogurt, also approved for binge eating disorder in adults, QD dosing

Answer 13

Vyvanse (lisdexamfetamine)

Question 14

This amphetamine formulation is a non-IR form, has 1/4 total dose each of 2 salt forms (each of amphetamine and dextroamphetamine), XR=50% IR and 50% XR beads), can sprinkle on food, approved for narcolepsy in adults, QD dosing

Answer 14

Adderall XR (d,l amphetamine/dextroamphetamine)

Question 15

This non-IR formulation of Methylphenidate has 22% IR and 78% ER, Has an OROS delivery system with biphasic release property, QD dosing

Answer 15

Concerta (d,l-methylphenidate)

Question 16

This non-IR formulation of methylphenidate is long acting=50% IR beads and 50% LA beads (enteric-coated, delayed-release), SODAS technology, can sprinkle on food, QD dosing

Answer 16

Ritalin LA (d,l-Methylphenidate)

Question 17

This Non-IR formulation of methylphenidate uses controlled delivery (CD)=30% IR and 70% CD (release-control polymer), may be emptied onto food, QD

Answer 17

Metadate CD (d,l-methylphenidate)

Question 18

This non-IR formulation of methylphenidate is XR=40% IR and 60% XR (multi-layer bead-releasing system), may be emptied onto food, QD dosing

Answer 18

Aptensior XR (d,l-methylphenidate)

Question 19

This non-IR formulation of methylphenidate is a patch, is methylphenidate in acryclic adhesive dispersed in silicone adhesive (DOT MATRIX technology), the wear time is individualizable (wear 9hrs=10-12 hr DOA), low abuse potential, QD dosing

Answer 19

Daytrana (patch) (d,l-methylphenidate)

Question 20

This non-IR formulation of methylphenidate is the only extended release CHEWABLE methylphenidate tablet, OralXR release technology (cherry flavored), XR=30% IR and 70% XR, QD dosing

Answer 20

QuilliChew ER (d-methylphenidate)

Question 21

This non-IR form of methylphenidate is the only extended release ORAL methylphenidate suspension, LiquiXR release technology, distributed as a powder requiring reconstituion prior to dispensing, SHAKE WELL, XR=20% IR and 80% XR, QD dosing

Answer 21

Quillivant XR (d-methylphenidate)

Question 22

This non-IR form of methylphenidate is under the category of Dexmethylphenidate, XR=50% IR beads and 50% XR (enteric-coated, delayed release beads), SODAS technology, can sprinkle XR product on food, QD dosing

Answer 22

Focalin XR (Dexmethylphenidate)

Question 23

Rare SE’s of stimulants? What must you diligently assess?

Answer 23

Suddent cardiac death –> Always assess for cardiac structural abnormalities

Stroke and MI –> seen in adults

Question 24

how does Atomoxetine enhance NT transmission?

Answer 24

Inhibition of NE pre-synaptic reuptake

Question 25

how do guanfacine/clonidine enhance NT transmission?

Answer 25

agonists of CNS alpha-2A adrenergic receptors

Question 26

For Non-stimulants…

• Onset of activity __ weeks
• Useful for what pts?
• Scheduled?
• *BIG STAR**

Answer 26

1-4+ weeks

Pts intolerant of stimulant effects or parents/pts resistant to using stimulant class

Non-scheduled, refills and samples permitted; up to 1 yr time frame

Question 27

This non-stimulant is a NET blocker, do NOT open capsules (eye irritant), metabolized by CYP2D6, QD

Answer 27

Atomoxetine (Strattera)

Question 28

Rare SEs of Atomoxetine?

BIG STAR

Answer 28

Suicidal ideations

Question 29

Caution with using Atomoxetine with what types of drugs?

Answer 29

MAOIs

CYP2D6 inhibitors

Question 30

What are the 2 non-stimulant, alpha-2-agonists?

Answer 30

Guanfacine and Clonidine

Do not crush,chew, or break tables; downward dose titration over 1+ weeks recommended upon discontinuation (risk of rebound HTN)

Question 31

SE of a2-agonists?

BIG STAR

Answer 31

Hypotension/bradycardia –> orthostatic hypotension