CNS Stimulants Flashcards
Classes of CNS stimulants
- Catecholamine releasers
- Catecholamine reuptake blockers
- Stimulant antidepressants
- Methylxanthines
- Nicotinic agents
Therapeutic uses of CNS sitmulants
- ADHD
- Narcolepsy
- Obesity
- Smoking cessation
- Alcohol use disorder? (varenicline)
Historical prototype of catecholamine releasers
D-ephedrine
Catecholamine releasers
- Amphetamine (Adderal)
- Methamphetamine (Desoxyn)
- Methylphenidate (Ritalin SR, Concerta, Metadate)
- Ephedrine
MOA of catecholamine releasers in CNS
- Binds to presynaptive membrane and induces release from vesicles
- Causes release of DA from vesicles into the intracellular space in terminal
- Blocks MAO, blocking degradation of DA and causing buildup inside cytoplasm in terminal
- Induces reverse transport through the DAT to “release” DA into EC space
Reuptake blockers
- Cocaine
- Modafinil (Provigil)
- Sibutramine (Meridia)
MOA of reuptake blockers
pure block of re-uptake, prolonging lifetime of catecholamine in the synapse and promoting its action on postsynaptic cell
Cocaine
abuse potential; short/intense action; NaV activity (locak anesthetic)
Modafinil (Provigil)
monoamine reuptake blocker; MOA unclear; less abuse potential than cocaine
What are bath salts?
Synthetic cathinones
Intoxication from synthetic cathinones
psychosis, hallucinations, agitation, tachycardia, hypertension, hyperthermia, and combative or violent behaviors
What is MDPV?
reuptake blocker for DAT and NET; 10-50X cocaine potency
Cathinones that are releasers have variable selectivity for
DAT, SERT, and NET
Stimulant antidepressants
- Atomoxetine (Strattera)
2. Bupropion (Zyban, Welbutrin)
Atomoxetine (Strattera)
Net activity; alternative to classical stimulants; refractory ADHD, ADD, and adult ADD
Bupropion (Zyban, Welbutrin)
Adjunct for depression/anxiety; smoking cessation; lowers seizure threshold
MOA of stimulant antidepressants
mixture of antidepressants properties (block NET or SERT) plus some mild CNS activating properties via block of DA reuptake
When are stimulant antidepressants used
used as alternative to classical stimulants, likely in situations refractory to first-line drugs
How is bupropion often used?
often used as an adjunct mood enhancer along with an SSRI, has NET and DAT blocking activity
Methylxanthines
- Caffeine
- Theophylline
- Theobromine
Caffeine
short-acting; diuretic; mild DA and NE stimulant
Theophylline
found in tea; bronchodilation, used in asthma