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NMSP Exam 3 > CNS Stimulants > Flashcards

CNS Stimulants Flashcards

1
Q

What are some stimulants for ADHD?

A
  • Amphetamine, Dextroamphetamine
  • Lisdexamfetamine
  • Methylphenidate, dexmethylphenidate
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2
Q

What are some non-stimulants for ADHD?

A
  • Atomoxetine
  • Guanfacine
  • Clonidine
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3
Q

What do stimulants do?

A
  • Enhance neurotransmitter transmission by serving as direct and indirect non-catecholamine sympathomimetics
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4
Q

What is the MOA of stimulants?

A
  • Block presynaptic reuptake
  • Interference with vesicular monoamine transporter (VMAT)
  • Increase in neurotransmitter release (NE, then DA, then 5-HT each at increasing doses)
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5
Q

Which isomers of AMP/MPH are more CNS active?

A
  • D-isomers over mixed or L-isomers
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6
Q

What is the main activity of methyphenidate?

A
  • Inhibition of DA reuptake and inhibition of neurotransmitter presynaptic reuptake
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7
Q

Does MPH stimulate neurotransmitter release?

A
  • MPH
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8
Q

What are some side effects of stimulants?

A
  • Dyspepsia/GI distress (N/V)/ Abdominal pain
  • Headache
  • Decreased appetite (weight loss and reduced growth progression)
  • Insomnia
  • Anxiety/Jitteriness
  • Irritability/Aggression/Agitation
  • Elevated BP/HR
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9
Q

What are some rare side effects of stimulants?

A
  • Priapism
  • Seizures
  • Sudden cardiac death
  • Stroke and MI
  • Chemical leukoderma
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10
Q

What are some formulation abbreviations?

A
  • Immediate release (IR)
  • Extended release (ER & XR)
  • Long acting (LA)
  • Controlled delivery (CD)
  • Oral disintegrating tablet (ODT)
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11
Q

What are some cautions when using stimulants?

A
  • Marked anxiety and agitation
  • Symptomatic CV disease
  • Moderate-to-severe HTN
  • Glaucoma
  • Motor tics or family history/diagnosis of Tourette’s syndrome
  • Ineffectively treated Bipolar/psychoses
  • Poorly controlled seizures
  • History of drug abuse
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12
Q

When is the onset of stimulants?

A
  • Usually 24 hours
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13
Q

What are some adverse effects of - Dextroamphetamine/AMP/Adderall, Dextroamphetamine sulfate/ProCentra, Amphetamine sulfate/Evekeo, and Dextroamphetamine/Zenzedi ?

A
  • Headache
  • Insomnia
  • Circulation problems
  • Decreased appetite
  • Slowing of growth
  • New psychotic problems
  • Nervousness
  • Dizziness
  • Diarrhea
  • Constipation
  • Increased tics
  • Stroke and MI
  • Increased BP/HR
  • Mood changes
  • New or worse bipolar illness
  • Aggressive behavior
  • Runny nose
  • Dry mouth
  • High potential for misuse and abuse
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14
Q

What is the form and duration of dextroamphetamine/AMP/Adderall?

A
  • Tab

- 4-6 hours

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15
Q

What is the form and duration of dextroamphetamine sulfate/ProCentra?

A
  • Liquid

- 4-6 hours

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16
Q

What is the form and duration of amphetamine sulfate/Evekeo?

A
  • Cap

- 4-6 hours

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17
Q

What is the form and duration of dextroamphetamine/Zenzedi?

A
  • Tab

- 4-6 hours

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18
Q

What are some immediate release forms of amphetamine-based stimulants?

A
  • Dextroamphetamine/AMP/Adderall
  • Dextroamphetamine sulfate/ProCentra
  • Amphetamine sulfate/Evekeo
  • Dextroamphetamine/Zenzedi
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19
Q

What are some extended release forms of amphetamine-based stimulants?

A
  • Dextroamphetamine/Adderall XR
  • Dextroamphetamine/Dexedrine
  • Amphetamine/Dyanavel XR
  • Lisdexamfetamine/Vyvanse
  • Amphetamine/Mydayis
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20
Q

What is the form and duration of Dextroamphetamine/Adderall XR?

A
  • CAP

- 8-12 hours

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21
Q

What is the form and duration of Dextroamphetamine/Dexedrine?

A
  • Cap

- 8-10 hours

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22
Q

What is the form and duration of Amphetamine/Dyanavel XR?

A
  • Liq

- 13 hours

23
Q

What is the form and duration of Lisdexamfetamine/Vyvanse?

A
  • Cap

- 10-12 hours

24
Q

What is the form and duration of Amphetamine/Mydayis?

A
  • Cap

- 16 hours

25
Q

What is a non-IR form of amphetamine?

A
  • Adzenys XR-ODT
  • 3:1 ration of d-amphetamine and l-amphetamine isomers
  • QD dosing
26
Q

What is the form and duration of dexmethylphenidate/Focalin?

A
  • Tab

- 4-6 hours

27
Q

What is the form and duration of Methylphenidate/Methylin oral solution?

A
  • Liq

- 3-4 hours

28
Q

What is the form and duration of methylphenidate/Ritalin?

A
  • Tab

- 3-4 hours

29
Q

What are some immediate release methylphenidate based stimulants?

A
  • Dexmethylphenidate/Focalin
  • Methylphenidate/Methylin oral solution
  • Methylphenidate/Ritalin
30
Q

What are some sustained release methylphenidate based stimulants?

A
  • Methylphenidate/Ritalin-SR

- Methamphetamine/Desoxyn

31
Q

What is the form and duration of Methylphenidate/Ritalin- SR?

A
  • Tab

- 4-8 hours

32
Q

What is the form and duration of Methamphetamine/Desoxyn?

A
  • 4-8 hours
33
Q

What are some extended release methylphenidate based stimulants?

A
  • Methylphenidate/Aptensio XR
  • Methylphenidate HCl/Concerta
  • Methylphenidate ER/ Cotempla XR-ODT
  • Methylphenidate transdermal/Daytrana
  • Dexmethylphenidate HCL/Focalin XR
  • Methylphenidate HCl/Metadate CD
  • Methylphenidate HCL ER/Ritalin LA
  • Methylphenidate HCl/Quillichew
  • Methylphenidate/ Quillivant XR
34
Q

What is the form and duration of Methylphenidate/Aptensio XR?

A
  • Cap

- 12 hours

35
Q

What is the form and duration of Methylphenidate HCL/Concerta?

A
  • Tab

- 10-12 hours

36
Q

What is the form and duration of Methylphenidate ER/Cotempla XR-ODT?

A
  • Tab

- 12 hours

37
Q

What is the form and duration of Methylphenidate transdermal/Daytrana?

A
  • Transdermal patch

- 10-12 hours

38
Q

What is the form and duration of Dexmethylphenidate HCl/Focalin XR?

A
  • CAP

- 6-10 hours

39
Q

What is the form and duration of Methylphenidate HCl/Metadate CD?

A
  • Cap

- 8-10 hours

40
Q

What is the form and duration of Methylphenidate HCl ER/Ritalin LA?

A
  • Cap

- 8-10 hours

41
Q

What is the form and duration of Methylphenidate HCl/Quillichew?

A
  • Chewable tablet

- 8 hours

42
Q

What is the form and duration of Methylphenidate/Quillivant XR?

A
  • Liq

- 8, 10, 12 hours

43
Q

What is the main effect of non-stimulants for ADHD?

A
  • Enhance neurotransmitter transmission via inhibition of NE presynaptic reuptake or agonists of CNS alpha2a adrenergic receptors
44
Q

What do the agonists of the alpha2a adrenergic receptors do?

A
  • Modulate noradrenergic tone in PFC by enhanced noradrenergic input from locus coeruleus
  • Direct postsynaptic stimulation of alpha2a receptors located on dendritic spines of cortical pyramidal cells, thereby directly promoting functional connectivity of PFC networks
45
Q

What is the onset of non-stimulants?

A
  • 1-4+ weeks
46
Q

Who is most likely to receive non-stimulants?

A
  • Patients intolerant of stimulant effects or parents/patients resistant to using stimulant class
47
Q

What is the form and duration of atomoxetine/Strattera?

A
  • Cap

- 24 hours

48
Q

What are some adverse effects of atomoxetine/Strattera?

A
  • Nervousness
  • Sleep problems
  • Fatigue
  • Upset stomach
  • Dizziness
  • Dry mouth
49
Q

Why should you not open atomoxetine capsules?

A
  • It is an ocular irritant
50
Q

What is the form and duration of clonidine/Kapvay ER?

A
  • Tab

- 12-24 hours

51
Q

What is the form and duration of guanfacine/Intuniv ER?

A
  • Tab

- 12-24 hours

52
Q

What are some examples of antihypertensives?

A
  • Clonidine

- Guanfacine

53
Q

What are some adverse effects of clonidine and guanfacine?

A
  • Fatigue
  • Drowsiness
  • Dizziness
  • Dry mouth
  • Decreased appetite
  • Constipation
  • Irritability
  • Low BP

NMSP Exam 3 (18 decks)

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