CNS Stimulants And Weight Loss Flashcards
CNS stimulants
Increase NE and dopamine. Dont want to give with a MAOI bc of DDI : HTN crisis
Quillivant XR
Methylphenidate XR oral susp
Ritalin, Ritalin LA / concerta
Methylphenidate
Metadate CD ; Metadate ER
Methylphenidate ER
Daytrana
Methylphenidate patch
Put patch on 2 hours before needed
Up to 9 hours on
Seems to a cause ticks in some. Switch if it does
Methylin
Methylphenidate
Dexmethylphenidate
Focalin XR
Dexedrine
Dextroamphetamine
Lisdexamefetamine
Vyvanse
Can’t abuse this like adderall
Modafinil
Provigil
Armodafinil
Nuvigil
Amphetamine + dextroamphetamine
Adderall
Atomoxetine
Strattera ( non stimulants )
MOA: selective NE reuptake inhibitor
Major thing we worry about is hepatotoxicity ( LFT )
Guanfacine
Intuniv
Alpha 2 agonist
Clonidine
Kapvay
Alpha 2 agonist.
Alpha 2 adrenergic agonist are usually reserved for children / adolescents ( 6 through 17 ) who respond poorly to stimulants or have unacceptable side effects. Alpha 2 agonist may take up to 2 weeks for initial response.
Stimulants adverse effects
Can slow growth ( monitor ). Drug holiday.
Palpitations, cardiac arrhythmias, angina, tachycardia
Weight loss, priapism emergency
DDI with MAOIs
HTN crisis
Viloxazine
Qelbree: a selective NE reuptake inhibitor for ADHD 6-17 years old.
Not controlled
Can open cap and sprinkled onto applesauce. Never chew or crush bc it’ll release all at once.
( recall atomoxetine also in capsules. Cannot open straterra )
Contraindication within 14 days of d/c MAOI. No linezolid , tedizolid, selegiline ( EMSAM )
1A2 inhibitor ( never combine with theophyline or clozapine )
Somnolence can occur in up to 38% of patients taking alpha 2 agonist.
T
Phentermine
Adopted P , Lomaira
C-4
Similar to amphetamines
No MAOIs
Orlistat
Xenical ( RX )
Alli ( OTC )
MOA: binds to fat. If patient doesn’t have a fatty meal dont take this. If you have fruit for lunch don’t take this.
When to take? With meal or up to hour after. If meal is skipped or no fat in meal, dont take.
SE: flatulence, fecal urgency, oily stool.
Malabsorption of fat soluble vitamins. ADEK. Counseling point: take fat soluble ( ADEK ) vitamins at least 2 hours before or after orlistat
Pregnancy category X
Qsymia
Phentermine + topiramate ER Caps
Topmax can cause kidney stones, stop sweating and cause hyperthermia
Topiramate can cause birth defects.
Contrave
Naltrexone + Buproprion
( contrave — contraaaindicated if you’re on opioids and if you have seizures )
Opioid antagonist + antidepressant
Duplicate therapy caution: If patient is Wellbutrin, or aplenzin( buproprion), or 450 or zyban dont add Contrave
Liraglutide
Saxenda for weight loss ( recall victoza for diabetes )
MOA: GLP-1 agonist.
Memorize dosing 3 mg subQ QD. ( in diabetes victoza: we use up to 1.8 mg subq QD ).
GLP-1 agonists: pancreatitis ( alcohol makes it worse )
