cns stimulant

Question 1

CNS stimulants

Answer 1

MOA: Inc NE and DO

Methylphenidate (Ritalin)
Methylphenidate XR oral SusP (Qullivant XR)
Methylphenidate patch ( Daytrana)
Dexmethylphenidate (Focalin)
Dextroamphetamine (Dexedrine)
Lisdexamfetamine (Vyvanse)
Dextromethorphan / Amphetamine ( Adderall)
Modafinil (Provigil)- narcolepsy
Armodafinil (nuvigil)- narcolepsy

Question 2

Non stimulant ADHD

Answer 2

1. Atomoxetine (Strattera)
2. Viloxazine (Quelbree)
3. Guanfacine ( Intuniv)- alpha 2 agonist
4. Clonidine ER (kapvaya)- alpha 2 agonist

Question 3

Stimulant adverse effect

Answer 3

• delayed sleep onset- avoid even dose
• HA, weight loss
• stimulate can slow growth; monitor growth
• CNS: irritability, insomnia
• CV: Inc HR, arrhythmia

Priapism are AE of methylphenidate and atomoxetine (erection lasting for >4hrs)

Question 4

DUR of Stimulants

Answer 4

MAO Inhibitor: Hypertensive crisis
- MaoI do not allow to metabolize NE, Epi and serotonis (Inc in NE, epi, 5ht3) and stimulant Inc NE so watch out for hypertensive crisis
- Food with high tyramine inc NE
- TCA

Question 5

methylphenidate IR

Answer 5

**Ritalin **

do not last long

• use with othe long lasting formualtion to provide boost early in morning

Question 6

Methylphenitdate ER/SR

Answer 6

**Ritilin LA **: bead filled (1/2IR and 1/2 XR)

**Concerta : OROS **
- 18, 27, 36, 54mg

Question 7

Methylphenidate transdermal patch

Answer 7

Daytrana patch
- apply to hip area
- worn daily for 9 hr (apply 2hr before desir effect) and Replace Qam

Question 8

Methylphenidate (Quillivant XR)

Answer 8

Extended release oral suspension

Question 9

Dexmethylphenidate

Answer 9

Focalin IR
Focalin XR
- QD in am
- caps can be sprinkle over applesauce

Question 10

dextroamphetamine

Answer 10

Dexedrine
Xelstrym- trtransdermal apply 2hr befor and effect is needed and remove within 9hrs

Question 11

Lisdexamphetamine

Answer 11

vyvanse (SR)

Question 12

dextroamphetamine/amphetamine salt mixture

Answer 12

Adderall IR
Adderall XR: QD Caps
Mydayis ER caps: QD qam

Question 13

Modafinil

Answer 13

Provigil - CIV
- Narcolepsy
- shift work sleep disorder

Question 14

Atomoxetine

Answer 14

Strattera
- Selective NE reuptake Inhib (Inc NE)
- SE: Liver injury, priapsim
- CI: MAOI

Question 15

Viloxazine

Answer 15

Qelbree
-Selective NE reuptake Inhib (Inc NE)
- caps can be sprinkle in tsp of apple sauce
- CI: MAOI

Question 16

Guanfacine

Answer 16

**Intuniv **
- non stimulant
- alpha-2 agonist (stimulate alpha- 2A adrenorecptor)
- SE: Somnolence

alpha 2 agonist sE: hypotension, HA, N/V, bradycardia , somnolence

Question 17

Clonidine ER Tabs

Answer 17

Kapvay
- Alpha 2 agonist
- SE: somnolence