CNS Stimulants

Question 1

What are the 2 general class options for ADHD treatment?

Answer 1

Stimulants

Non-stimulants

Question 2

IR

Answer 2

Immediate Release

Question 3

ER or XR

Answer 3

Extended Release

Question 4

LA

Answer 4

Long Acting

Question 5

CD

Answer 5

Controlled Delivery

Question 6

ODT

Answer 6

Oral Disintegrating Tablet

Question 7

What are the 2 types of Stimulants?

Answer 7

Amphetamine based

Methylphenidate based

Question 8

What are the 2 types of Stimulants?

Answer 8

Amphetamine based

Methylphenidate based

Question 9

What are the 3 Non-Stimulants?

Answer 9

Atomoxetine
Guanfacine
Clonidine

Question 10

What are the 3 Non-stimulants?

Answer 10

Atomoxetine
Guanfacine
Clonidine

Question 11

What is the MOA for Stimulants?

Answer 11

Enhance neurotransmitter transmission by serving as direct/indirect non-catecholamine sympathomimetics

Question 12

Stimulants can block neurotransmitter reuptake, interfere with VMAT and increase release. As the dose increases, what neurotransmitter effects will occur?

Answer 12

As dose increases:

• NE
• • Then DA
• – Then 5-HT

Question 13

What are some general side effects of the Stimulants? (4)

Answer 13

GI distress
Decreased appetite and growth
Insomnia
Jittery

Question 14

What are some rare side effects of the Stimulants? (4)

Answer 14

Priapism – extended erection
Seizures
Chemical Leukoderma
Cardiac deaths

Question 15

How long does it take for the onset of activity for Stimulants?

Answer 15

24 hours

Question 16

Stimulants are controlled substances - yes or no?

Answer 16

YES

- 1-3 month supply, no refills, no samples

Question 17

Amphetamine based IR forms?

Answer 17

Tablet
Capsule
Liquid

Question 18

Amphetamine based IR forms?

Answer 18

Tablet
Capsule
Liquid

Question 19

Amphetamine based ER forms?

Answer 19

Capsule

Liquid

Question 20

Amphetamine based ER forms?

Answer 20

Capsule

Liquid

Question 21

Amphetamine based also has an XR-ODT form. Describe it.

Answer 21

Extended release oral disintegrating tablet

– NO water necessary!

Question 22

The XR-ODT form of Amphetamine has what ratio of d:l amphetamine?

Answer 22

3:1

Question 23

Methylphenidate based IR forms?

Answer 23

Tablet

Liquid

Question 24

Methylphenidate based IR forms?

Answer 24

Tablet

Liquid

Question 25

Methylphenidate based SUSTAINED release forms?

Answer 25

Tablet

Question 26

Methylphenidate based SUSTAINED release forms?

Answer 26

Tablet

Question 27

Methylphenidate based ER forms?

Answer 27

``` Tablet Capsule Liquid Chewable tablet Transdermal patch ```

Question 28

Methylphenidate based ER forms?

Answer 28

``` Tablet Capsule Liquid Chewable tablet Transdermal patch ```

Question 29

What is the Methylphenidate based stimulant that is ER and can be worn as a transdermal patch?

Answer 29

Methylphenidate transdermal

Question 30

What side effect can occur with the Methylphenidate based ER transdermal patch form?

Answer 30

Chemical Leukoderma

Question 31

What is the Methylphenidate ER form that is a chewable tablet?

Answer 31

Methylphenidate HCI

Question 32

What is the MOA for Atomoxetine?

Answer 32

(-) NE reuptake

Question 33

What form is Atomoxetine given in?

Answer 33

Capsule

Question 34

What are the possible side effects of Atomoxetine?

Answer 34

Ocular irritant if capsule opened | Suicidal thoughts

Question 35

What is the MOA for Guanfacine and Clonidine?

Answer 35

CNS Alpha2a receptor Agonists

Question 36

What form is Guanfacine and Clonidine given in?

Answer 36

Tablet

Question 37

Guanfacine and Clonidine are actually _____

Answer 37

Antihypertensives

Question 38

What are there risks or/warning to not do with Guanfacine and Clonidine?

Answer 38

Risk of Rebound HTN | Do not crush, chew, break tablets

Question 39

With Guanfacine and Clonidine there is a risk of Rebound HTN, how should you discontinue the meds?

Answer 39

Downward dose titration for 1+ weeks

Question 40

How long does the onset of activity take to occur with Non-Stimulants?

Answer 40

1-4+ weeks

Question 41

Non-stimulants are controlled substances - yes or no?

Answer 41

NO | -- refills and samples permitted

Question 42

In what patients are Non-stimulants useful?

Answer 42

Patients/parents intolerant of stimulant effects

Question 43

Compare the effect-size of Non-stimulants to Stimulants?

Answer 43

Non-stimulants effect-size NOT as large as seen with Stimulants

Question 44

Compare the effect-size of Non-Stimulants to Stimulants?

Answer 44

Non-Stimulants effect-size NOT as large as seen with Stimulants