CNS Stimulants

Question 1

Neuroimaging on ADHD

Answer 1

Reduced frontal lobe volume & metabolism

Question 2

Methylphenidate

Answer 2

Ritalin (Stimulant)

-Treats ADHD and narcolepsy

Question 3

Dexmethylpenidate

Answer 3

Stimulant

Question 4

Dextroamphetamine / amphetamine

Answer 4

Adderall (stimulant)

-Treats ADHD, narcolepsy, and and weight contorl

Question 5

Why mixed amphetamine salts?

Answer 5

75% dextro enantiomer (more potent) 25% devo enantiomer (longer half life and fewer side effects)

Question 6

Stimulant (amphetamines) mechanism of action

Answer 6

-inhibits DAT (inhibits DA reuptake)
-blocks VMAT storage vesicles
—> increased NE and DA released and in synapse

Question 7

Stimulant adverse effects

Answer 7

• Reduced appetite, weight loss
• GI upset
• insomnia
• headache
• rebound symptoms
• irritability

Question 8

Methamphetamine

Answer 8

Stimulant-
“Poor man’s cocaine” crystal meth/speed/ice
-Treats ADHD and weight control
-fast acting: immediate stimulation/euphoria- higher potential for addiction/abuse
-tolerance
-can cross placenta and breast milk
-half life: 8-12 hrs

Question 9

Cocaine

Answer 9

Stimulant- coke/crack/flake/snow
-local anesthetic (rarely used this way)
—| reuptake of DA, NE, 5-HT (—| DAT, NET, SERT)
—> euphoria, increased SNS activity
—> fight or flight in periphery
-half life: 1-2 hrs

Question 10

Atomexetine

Answer 10

NE reuptake inhibitor- better for adults

-2+ lag until effects appear

Question 11

Guanfacine

Answer 11

Non stimulant: A2 adrenergic agonist —> in PFC enhances executive functioning, attentiveness, and working memory

Question 12

Clonidine

Answer 12

Non-stimulant: A2 adrenergic agonist —> in PFC enhances executive functioning, attentiveness, and working memory

Question 13

Rebound effects of cocaine

Answer 13

Depression, fatigue, drowsiness

Question 14

Cocaine adverse effects

Answer 14

Cardiac dysrhythmias, MI, seizures, stroke, death

• toxic paranoid psychosis (4-8 hrs after drug cessation) aggressive homicidal behavior
• psychological dependence

Question 15

Dangers of “crack” cocaine

Answer 15

Free base- highly addictive after first dose

Question 16

Crack babies

Answer 16

Babies who got cocaine in utero (crosses placental barrier) or from breast milk

• will go through withdrawal symptoms but not addicted!
• Treat the symptoms

Question 17

Speedballing

Answer 17

Inject cocaine in one arm and heroin in another (mix uppers and downers)
-cocaine will offset the respiratory depression of heroin to some degree so they can use huge doses but get extremely high psych effects

Question 18

Treat cocaine withdrawal

Answer 18

• antipsychotics
• antidysrhythmics
• anxiolytics/antidepressents

Question 19

Cocaine OD treatment

Answer 19

None!

Question 20

Methamphetamine adverse effects

Answer 20

• dry mouth (increased opportunities for infection)

- oral damage: “meth mouth”

Question 21

Methamphetamine OD treatment

Answer 21

None!

Question 22

Methamphetamine withdrawal symptoms

Answer 22

Same as cocaine but longer duration

-meth paranoia: 7-14 days after drug cessation

Question 23

Treat methamphetamine withdrawal

Answer 23

A`-adrenergic antagonist (prazosin)

• antipsychotics
• anxiolytics
• antidepressants

Question 24

GHB

Answer 24

Gamma hydroxybutyric acid

• date rape drug
• stimulant

Question 25

MDMA

Answer 25

Ecstasy

• derivative of methamphetamine
• affects 5-HT > NE
• feel like they love people more
• can cause serotonin syndrome

Question 26

Bath salts

Answer 26

Amphetamine-like stimulant designer drugs called cathiones

-look like Epsom salts