Chapter 39 - CNS Stimulants and ADHD Flashcards
What do CNS stimulants do?
increase the activity of CNS neurons
What is a major AE of all CNS stimulants (in sufficient doses)?
seizures
What are CNS stimulants used for?
ADHD and narcolepsy
How do amphetamines act?
by releasing DA, NE via inhibiting reuptake in neurons
Amphetamines affect which 2 systems?
CNS and CV
What aspects of tolerance can develop to amphetamines with regular use?
-elevation of mood
-apetite suppression
-stimulation of heart and blood vessels
Do users of amphetamines gain physical dependence?
yes, abstinence syndrome can develop with abrupt withdrawal
Why do amphetamines have a high potential for abuse?
euphoric feelings
What are the adverse effects of amphetamines?
-CNS stimulation
-weight loss
-CV effects
-psychosis
What are the symptoms of acute amphetamine toxicity?
-dizziness
-confusion
-hallucinations
-paranoid delusions
-palpitations
-dysrhythmias
-hypertension
-death (RARE)
Fatal overdose via amphetamines can look like:
-convulsions
-coma
-cerebral hemorrhage
What is the tx for hallucinations caused by amphetamine toxicity?
chlorpromazine
What is the tx for hypertension caused by amphetamine toxicity?
Alpha blocker (phentolamine) or chlorpromazine
What is the tx for seizures caused by amphetamine toxicity?
diazepam
What is another way to speed up amphetamine excretion?
acidifying urine
What is the immediate release form of dextroAMPHETAMINE sulfate called?
Dexedrine
What is the extended release form of detroAMPHETAMINE sulfate called?
Dexedrine Spansule
What is the brand name of amphetamine/levoamphetamine salts?
adderall XR
LisdexAMPHETAMINE is a __________ and is available as tablets or capsules
pro-drug
What is methylphenidate?
an amphetamine-like drug used for ADHD and narcolepsy
Methylxanthines are derivatives of ___________
xanthine
What type of CNS stimulant is caffeine?
a methylxanthine
Caffeine is found in…
-chocolate
-soft drinks
-energy drinks
-coffee
-tea
How do methylxanthines act?
-reversible blockade of ADENOSINE receptors
-enhancing CALCIUM permeability in sarcoplasmic reticulum
-accumulates cAMP
What do methylxanthines do in low doses?
decrease fatigue and increase capacity for prolonged brain power
In high doses methylxanthines cause…
-nervousness
-insomnia
-tremors
Large amounts of methylxanthines can cause _____________
seizures
Methylxanthines have effects on:
-CNS
-heart and vessels
-bronchi
-kidneys
-reproduction
Methylxanthines achieve peak plasma levels in _____ hour(S)
1
Where are methylxanthines readily absorbed?
GI tract
What is another use for methylxanthines besides promoting wakefulness?
neonatal apnea
Acute methylxanthine toxicity causes:
-CNS stimulation
-tachycardia
-respiratory stimulation
What is Modafinil used for?
-promoting wakefulness
-narcolepsy
-shift-work
-obstructive sleep apnea
-jet lag, MS fatigue (off label)
What is the half life of Modafinil?
15 hrs
What are the adverse effects of Modafinil?
-headache
-nausea
-nervousness
-increased HR and BP
-skin reactions
What does Modafinil interact with?
OC’s
What drugs are used for ADHD in kids?
-methylphenidate
-dextroamphetamine
-adderall
-atomoxetine (non-stimulant_
-A2 agonists
-antidepressants
How does Atomoxetine act?
selectively inhibits NE reuptake
Plasma Atomoxetine levels peak in ______ hour(S)
1-3
What are the adverse effects of atomoxetine?
-GI
-reduced appetite
-dizziness
-somnolence
-mood swings
-insomnia
-SUICIDAL IDEATION
-caution in CVD
