CNS Stimulants

Question 1

What are the two classes of ADHD medications?

Answer 1

Stimulants (Amphetamine Derivatives) and Non-Stimulants

Question 2

What are the Non-Stimulants used for ADHD?

Answer 2

Atomoxetine, Guanfacine, and Clonidine

Question 3

What is the mechanism of action of stimulants?

Answer 3

They enhance neurotransmitter transmission by serving as direct & indirect non-catecholamine sympathomimetics

Question 4

What is the difference between the isomers of AMP/MPH?

Answer 4

D-isomers of AMP/MPH have more CNS activity than mixed or L-isomers

Question 5

What is the main MOA of methylphenidate?

Answer 5

Inhibition of dopamine reuptake & inhibition of neurotransmitter pre-synaptic reuptake

Question 6

Which stimulant can cause Chemical Leukoderma, a rare side effect?

Answer 6

a Daytrana Patch

Question 7

What are the regulations for prescribing stimulants?

Answer 7

Stimulants are controlled substances

1 month supply only, no refills, no samples

Question 8

Adderall is what kind of drug? Prescribed how?

Answer 8

Adderall is the brand name for Dextroamphetamine

Prescribed as a tablet, lasts 4-6hrs

Question 9

ProCentra is what kind of drug? Prescribed how?

Answer 9

ProCentra is the brand name for Dextroamphetamine Sulfate

It is prescribed as a liquid, and lasts 4-6hrs

Question 10

Evekeo is what kind of drug? Prescribed how?

Answer 10

Evekeo is the brand name for amphetamine sulfate

Prescribed as a capsule, lasts 4-6

Question 11

Zenzidi is what kind of drug? Prescribed how?

Answer 11

Zenzidi is the brand name for dextroamphetamine

Prescribed as a tablet, lasts 4-6 hrs

Question 12

Extended Release Amphetamine-Based Stimulants usually come in which form?

What is the one exception?

Answer 12

Capsule

Exception: Dynavel XR comes in a liquid form

Question 13

What is special about Adzenys XR-ODT?

Answer 13

Usually used for younger children with ADHD

Can be dissolved sublingually

Question 14

Dexmethylphenidate (Focalin) is prescribed in which form?

Answer 14

tablet

Question 15

What are the two forms that Methylphenidate can be prescribed in?

Answer 15

Methylin is the brand name version which is prescribed as a liquid

Ritalin is the brand name version which is prescribed as tablets

Question 16

What is the duration and formulation for Sustained Release Methylphenidate?

Answer 16

Lasts 4-8 hrs and comes in tablet form

Question 17

Methylphenidate HCL, known as QuilliChew, is what kind of drug? And what formulation?

Answer 17

It is an Extended Release Methylphenidate, which comes in chewable tablet form

Question 18

What is the liquid form of ER Methylphenidate known as?

Answer 18

Quillivant XR

Question 19

What are the key Mechanisms of Action of Non-Stimulants used to treat ADHD?

Answer 19

• Main effect of non-stimulants is to enhance neurotransmitter transmission via:
• Inhibition of NE pre-synaptic reuptake

-Agonists of CNS α2A adrenergic receptors

Question 20

What makes non-stimulants unique in their use for treating ADHD?

Answer 20

-Onset of activity is 1-4+ weeks

-Useful for patients intolerant of stimulant effects

Question 21

What are the regulations for prescribing non-stimulants?

Answer 21

-Non-scheduled, refills & samples permitted up to 1 year time-frame

Question 22

What is the main non-stimulant that is prescribed? What form does it come in?

Answer 22

Atomoxetine (Strattera ER)

Comes in capsule form

Question 23

Which anti-hypertensives can be used to treat ADHD?

Answer 23

Clonidine(Kapvay) and Guanfacine(Intuniv)

Question 24

What is the risk involved in using anti-hypertensives for ADHD?

Answer 24

Upon discontinuation, there is a risk of rebound hypertension

-therefore, it is recommended to have a downward dose titration upon discontinuation