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Pharm 845 Final Exam > Dr. Masserano: ADHD/Narcolepsy/Stimulants > Flashcards

Dr. Masserano: ADHD/Narcolepsy/Stimulants Flashcards

1
Q

Catecholamine Analogs

A
  • Longer acting
  • Lipid soluble
    1) Removal of 3-OH group protects from COMT metabolism
    2) Alpha methyl group protects from MAO metabolism
    3) Removal of all OH groups increases lipid solubility and CNS entry
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2
Q

Uses of Stimulants

A

1) ADHD
2) Short term treatment of obesity
3) Narcolepsy

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3
Q

Xyrem (GHB)

A
  • Used for Narcolepsy with cataplexy
  • Schedule 3 when used medically
  • Schedule 1 when abused
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4
Q

Which drugs can be used for ADHD

A
  • Amphetamines
  • Methamphetamine
  • Lisdexamphetamines
  • Methylphenadine
  • Atomoxetine
  • Clonidine
  • Guanfacine
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5
Q

Which drugs can be used for Narcolepsy

A
  • Amphetamines
  • Methylphenadate
  • Solriamfetol
  • Modafinil
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6
Q

Which Drugs can be used for Obesity

A
  • Methamphetamine
  • Phentermine
  • Osymia
  • Diethylpropion
  • Lorcaserin
  • Victoza
  • Saxenda
  • Contrave
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7
Q

Amphetamines MoA

A
  • Stimulate the release of NE and DA

- Inhibit the reuptake of NE and DA

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8
Q

Adderall

A

-FDA warning: Cardiac abnormalities and serious cardiac problems in children

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9
Q

Methamphetamine (Desoxyn, Methampex) MoA

A

-Used for ADHD and Obesity

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10
Q

Lisdexamfetamine (Vyvanse) MoA

A
  • Treatment of ADHD and Eating Disorder
  • Inactive prodrug
  • Limits abuse potential
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11
Q

Methylphenidate (Ritalin) MoA

A
  • Treatment of ADHD, Narcolepsy, Major Depression

- Daytrana: once daily patch, useful for children who cannot swallow pills

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12
Q

Concerta (Methylphenidate ER)

A
  • Contains polyethylene oxide
    1) Insoluble in alcohols
    2) Viscous gel when mixed with water
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13
Q

Phentermine (Adipex-P, Fastin, Ionamin)

A
  • Increases NE and DA release
  • Inhibits NE and DA reuptake
  • Short term treatment of obesity
  • BMI > 30
  • BMI >27 with risk factors
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14
Q

Osymia (Phentermine and Topiramate)

A
  • Short term treatment of obesity
    1) prolongs inactivation period of Na+ channels
    2) AMPA/Kainate antagonist
  • Do NOT use in pregnancy
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15
Q

Diethylpropion (Tenuate)

A
  • Stimulates the release of NE and DA

- Short term management of obesity

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16
Q

Phenylpropanolamine

A
  • OTC drug
  • Used for nasal decongestant
  • And treatment of obesity???
  • Women are at a 15x higher risk of stroke
17
Q

Ephedrine MoA

A
  • Releases andogenous NE
  • Effects on beta receptors
  • FDA prohibits dietary supplements containing ephedrine
18
Q

Therapeutic uses of Ephedrine

A

1) Acute bronchospasm
2) Hypotension
3) Orthostatic hypotension
4) Nasal congestion
5) Nighttime enuresis

19
Q

Pseudophedrine (Sudafed)

A
  • OTC drug

- Mostly effects alpha receptors

20
Q

Therapeutic uses for pseudoephedrine

A

1) Nasal congestion
2) Otalgia prophylaxis
3) Urinary incontinence

21
Q

Lorcaserin (Belviq)

A
  • Antiobestity drug
  • BMI >30 or >27 with other factors
  • Serotonin syndrome, suicidal thoughts, heart disease
22
Q

Nexafed

A
  • Pseudoephedrine tablet designed to help curb methamphetamine production
  • Turns into thick gel when dissolved
  • Makes it harder to make meth
23
Q

Contraindications for all amphetamine type stimulant drugs

A

1) Cardiac disease
2) Hyperthyroidism
3) Closed angle glaucoma
4) Psychosis

24
Q

Drug interactions with All amphetamine type stimulant drugs

A

1) Enhance the effects of sympathomimetics
2) Do NOT use with MAOIs
3) May counteract the effects of some antihypertensive agents
4) Antipsychotics may lower the efficacy of these drugs

25
Q

Side effects of All amphetamine type stimulant drugs

A

1) Anxiety, insomnia, headache
2) Mydriasis, paranoia
3) Increased BP and HR
4) Growth inhibition
5) Reverse tolerance (sensitization)

26
Q

Modafinil (provigil)

A
  • CNS stimulant
  • Minimal peripheral side effects
  • Approved for: narcolepsy and other sleep disorders
27
Q

Solriamfetol (Sunosi)

A
  • Used for sleep disorders

- Inhibits DA and NE reuptake

28
Q

Atomoxetine (Strattera)

A
  • Approved for ADHD in children and adults
  • NE reuptake inhibitor
  • 1st line in pts with substance abuse disorder
  • BLACK BOX WARNING: suicidal ideation in children
29
Q

Clonidine (Kapvay) and Guanfacine (intuniv)

A
  • Treatment of ADHD in children ages 6 to 17
  • Side effects:
  • Sedation
  • Rebound hypertension
  • Less side effects with guanfacine
30
Q

Orlistat (Xenical)

A
  • Inhibitor of pancreatic lipase

- Used to treat obesity

31
Q

Victoza (Liraglutide)

A
  • GLP1 agonist
  • Inhibits glucagon secretion
  • Approved for type 2 diabetes
  • BLACK BOX WARNING: Risk of thyroid C cell tumors
32
Q

Saxenda (Liraglutide)

A
  • FDA approved for weight loss

- BLACK BOX WARNING: Risk of thyroid C cell tumors

33
Q

Contrave (Bupropion/naltrexone)

A
  • FDA approved for weight loss

- BLACK BOX WARNING: suicidality and neuropsychiatric reaction

Pharm 845 Final Exam (7 decks)

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