CNS stimulants

Question 1

what are the three classes of CNS stimulants?

Answer 1

analeptics and respiratory stimulants
methylxanthines
sympathomimetic amides - psychomotor stimulants

Question 2

what is the analeptic / respiratory stimulant agent?

Answer 2

doxapram

Question 3

what is the MOA of doxapram?

Answer 3

binds to carotid artery chemoreceptors and medullary respiratory centers to increase tidal volume and RR

Question 4

what is the clinical use of doxapram?

Answer 4

counteract postanesthetic respiratory depression

Question 5

what are the methylxanthine CNS stimulants?

Answer 5

caffeine

theophylline

Question 6

what is the primary clinical use for caffeine?

Answer 6

apnea of prematurity

Question 7

what is the primary clinical use for theophylline?

Answer 7

COPD

asthma

Question 8

what is the MOA of theophylline?

Answer 8

relaxes bronchial smooth muscle

Question 9

what are the sympathomimetic amide CNS stimulants?

Answer 9

amphetamine and analogues

methamphetamine 
dexamphetamine 
methylphenidate 
cocaine 
modanifil

Question 10

which sympathomimetic amide CNS stimulant has a MOA that involves inhibition of NE reuptake?

Answer 10

atomoxetine

Question 11

how are CNS stimulants degraded in the periphery?

Answer 11

MAOa and MAOb

Question 12

where are CNS stimulants metabolized? how?

Answer 12

liver

microsomal p450s

Question 13

which drugs should be avoided with CNS stimulant use? why?

Answer 13

MAOIs and SSRIs

increased levels of monoamines

Question 14

how are CNS stimulants excreted?

Answer 14

urine

Question 15

what is the general MOA for analeptic stimulants?

Answer 15

depression of inhibitory neurotransmission

GABA and glycine antagonists - decrease chloride influx and hyperpolarization

Question 16

what is the general MOA for methylxanthines?

Answer 16

inhibition of CNS suppressant

reduce adenosine activity by A1 receptor antagonism

Question 17

what is the general MOA for amphetamines?

Answer 17

enhancement of excitatory transmission

Question 18

what is the general MOA for cocaine?

Answer 18

enhancement of excitatory transmission

inhibition of monoamine uptake via blockade of DA and NE transporters

Question 19

what is the general MOA for atomoxetine?

Answer 19

enhancement of excitatory transmission

selective NE transporter blockade

Question 20

what is the clinical use for methylphenidate?

Answer 20

ADHD

Question 21

what is the clinical use for modanifil?

Answer 21

narcolepsy and sleep disorders

Question 22

which CNS stimulant is used for obesity?

Answer 22

amphetamine

Question 23

which schedule regulation is assigned to amphetamine?

Answer 23

schedule II

Question 24

which brain area involved in the reward pathway is affected by cocaine?

Answer 24

ventral tegmental area

Question 25

what are the CNS side effects of psychomotor stimulants?

Answer 25

``` euphora dysphoria insomnia irritability tremor headache loss of appetite ```

Question 26

what are the CV side effects of psychomotor stimulants?

Answer 26

MI, stroke

Question 27

which psychomotor stimulant is associated with steven johnson syndrome? what other side effect is associated with this drug?

Answer 27

modafinil skin rashes

Question 28

which agents are used to treat ADHD?

Answer 28

methylphenidate - ritalin amphetamine salts - adderall, adderall XR dextroamphetamine - dexedrine, dextrostat

Question 29

what are the non-stimulant agents used to treat ADHD?

Answer 29

atomoxetine clonidine modafinil antidepressants - TCAs, MAOIs, bupropion

Question 30

which non-stimulant agent used to treat ADHD is FDA approved?

Answer 30

atomoxetine

Question 31

what is the MOA of atomoxetine?

Answer 31

selective NE reuptake blocker

Question 32

what are the side effects in ADHD treatment?

Answer 32

decreased appetite and weight loss | insomnia