CNS Stimulants (Iszard)

Question 1

Basic action of stimulants

Answer 1

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

Question 2

normal side effects of stimulants (6)

Answer 2

• dyspepsia/GI distress
• headache
• decreased appetite
• insomnia
• anxiety
• elevated BP/HR

Question 3

rare side effects of stimulants (5)

Answer 3

• priapism
• seizures
• sudden cardiac death
• stroke/MI
• chemical leukoderma (with patch use)

Question 4

onset of activity of stimulants

Answer 4

24 hours in most patients

Question 5

Prescribing stimulants

Answer 5

stimulants are CONTROLLED SUBSTANCES (1 month supply only, no refills, no samples)

Question 6

Immediate release amphetamine-based stimulant that comes in LIQ form

Answer 6

Dextroamphetamine sulfate/Procentra

Question 7

Extended release amphetamine-based stimulant that comes in LIQ form

Answer 7

Amphetamine/Dyanavel XR

Question 8

Oral disintegrating tab form of amphetamine

Answer 8

Adzenyz XR-ODT

Question 9

immediate release, methylphenidate-based stimulant in LIQ form

Answer 9

Methylphenidate/Methylin Oral Solution

Question 10

extended release, methylphenidate-based stimulant in transdermal patch form

Answer 10

methylphenidate transdermal/daytrana

Question 11

extended release, methylphenidate-based stimulant in chewable tablet form

Answer 11

methylphenidate HCL/QuilliChew

Question 12

extended release, methylphenidate-based stimulant in liquid form

Answer 12

methylphenidate/Quillivant XR

Question 13

MOA non-stimulants (for ADHD)

Answer 13

enhance neurotransmitter transmission via:

1) inhibition of NE pre-synaptic reuptake
2) agonists of CNS alpha-2 adrenergic receptors

Question 14

onset of activity for non-stimulants

Answer 14

1-4+ weeks

Question 15

When to use non-stimulants

Answer 15

useful for patients intolerant of stimulant effects or parents/patients resistant to using stimulant-class

Question 16

Non-stimulant medication in CAP form that has a risk of suicidal thoughts

Answer 16

Atomoxetine/Strattera (Extended release)

Question 17

Non-stimulant medications in TAB form that are anti-hypertensives (2)

Answer 17

1) Clonidine

2) Guanfacine

Question 18

Nonstimulant/Anti-hypertensives MOA

Answer 18

alpha-2 agonists

Question 19

What is the risk with discontinuation of non stimulant/antihypertensives?

Answer 19

Risk of rebound HTN if they are not discontinued with a downward dose titration over 1+ weeks