Kiddo Drugs Flashcards
What is the number 1 drug abused on college campuses?
Methylphenidate (ritalin)
What is the most commonly prescribed drug to treat ADHD in children?
Methylphenidate (ritalin)
Methylphenidate:
Drug Class
Therapeutic Use
amphetamine based (^^NE, DA, 5HT) ADHD, Narcolepsy
Concerta:
Drug Class
Therapeutic Use
Special feature*
Methylphenidate based
ADHD, Narcolepsy
*Extended release tablet
Metadate CD:
Drug Class
Therapeutic Use
Special feature*
Methylphenidate based
ADHD, Narcolepsy
*Effective throughout the day/ biphasic release
Focalin:
Drug Class
Therapeutic Use
Special feature*
Methylphenidate based
ADHD, Narcolepsy
D-isomer; prescribe at 1/2 dose
Daytrana:
Drug Class
Therapeutic Use
Special feature/ROA*
Methylphenidate based
ADHD, Narcolepsy
Administered in patch form; good for temperamental kids who refuse to take meds (6-12 y/o)
MOA for all Methylphenidate based drugs?
- ^ NT in central NE/DA systems
- non-competitive inhibit NE, DA reuptake
- MAOi
5 Effects of Methylphenidate based drugs?
- ^ attention, concentration, talkativeness
- ^ vigilance, wakefulness
- decrease fatigue, appetite
* used to be dietary supplement - ^ mood, elation, euphoria, self confidence
- ^ psychomotor stim
3 Important ADR of Methylphenidate based drugs?
- (#1) GI upset/ abdominal pain/ weight loss
- restlessness/ anxiety/ insomnia
- Convulsions w/ high doses
3 contraindications for Methylphenidate based drugs?
- Seizure disorders
- glaucoma
- Hx drug abuse
MOA for all Amphetamines
Therapeutic Use?
Dose dependent release of NE/ DA / 5HT (^ Doses do all 3)
Tx: ADHD, Narcolepsy
What are the effects of amphetamines?
How do they differ from Methylphenidate based drugs?
- Effects are the same
- More side effects
- Higher abuse potential
4 Contraindications to amphetamine use:
- CVD
- Glaucoma
- MAOi
- Hx of drug abuse
Describe the ADRs associated with amphetamine use?
How would you treat a seizure induced by amphetamines?
Same as methylphenidate based drugs but more severe; treat convulsions in ED with BDZ
Adderall /Adderall XR:
Drug class
Amphetamines
Dextroamphetamine:
Drug Class
Amphetamines
Lisdexamfetamine:
Drug class + special feature
Amphetamines
prodrug for Dextroamphetamine
Atomoxetine: MOA Therapeutic Use Metabolism? CI (2)?
Selective NE reuptake inhibitor
Tx: ADHD in kids > 6yo, adults w/ abuse hx
Metabolism: CYP2D6 (watch for poor metabolizers)
CI: CVD*, MAOi
Clonidine, Guanfacine:
MOA
Therapeutic use? Good for which group?
CI
a2 Adrenergic Agonist
Guanfacine is guana bind a2
Used as second line ADHD treatment; good for kids with aggression
CI: CVD
Which three “groups” of drugs can be used to treat kids with oppositional defiant/ conduct disorder?
- ADHD meds (methylphenidate, amphetamines, a2 agonists)
- Mood stabilizers (lithium, valproate)
- Atypical antipsychotics (risperidone, aripiprazole)
Dosing of ADHD drugs for ODD, CD?
kids get higher dose than those treated for just ADHD
Which childhood disorder is thought to be a precursor to bipolar disease/ antisocial PD?
Conduct disorder
What does Lithium do for kids with ODD/ CD
control aggression
- Watch SE’s!
- May administer with antipsychotic, in which case REALLY watch SE’s
What does valproate do for kids with ODD/ CD
stabilize mood
* May administer with antipsychotic–> watch SE’s
Atypical antipsychotics that are OK to give to kids with ODD/ CD (2)
- Risperidone
- Aripiprazole
** Avoid both if possible due to high SE profile
(metabolic effects)
4 Drugs to treat ADHD asstd Autism Spectrum Disorder (ASD) Inattention an Hyperactivity
- Methylphenidate***
- α2 adrenergic agonists
- Atomexatine
- Risperidone
*** = most important/ discussed in class
2 Drugs to treat ANXIETY asstd Autism Spectrum Disorder (ASD) Inattention an Hyperactivity
- SSRI*** (good for repetitive bx./ rigidity too)
- Buspirone (5HT agonist)
*** = most important/ discussed in class
When do we medicate disruptive bx in children with ASD?
Disruptive bx occurs when their routine is in jeopardy; only medicate if the bx is chronic, i.e. more than 1 x per week and not asstd. with obvious disruption of routine
Drugs used to treat disruptive bx in ASD (5)
- Atypicals
- α2 adrenergic agonists
- Mood stabilizers
- anti epileptics
- SSRI
Drug treatment of repetitive bx and rigidity in ASD (3)
- Fluoxetine (SSRI)***
- Clomipramine (TCA)
- Risperidone
*** = most important/ discussed in class
Drug treatment of sleep disturbance in ASD (3)
- Melatonin/ Ramelton***
- Risperidone
- SSRI
*** = most important/ discussed in class
Atypical antipsychotics used to treat Tourettes + their MOA (2)
- Fluphenazine
- Pimozide
D2 Antagonism
Tetrabenzine:
MOA
Therapeutic use in childhood disorders
VMAT2 inhibitor–> increase DA metabolism in cytosol
Tx: Tourettes
Which childhood disorder is Botox used to treat?
Facial tics in tourettes
Desmopressin:
MOA
Therapeutic Use
Caveat?
- Synthetic vasopressin analog; regulates water reabsorption in collecting tubule
- Administer 1 hr before bed time to treat enuresis in kiddos
- COSTS MAD MO’ $$$$!
Imipramine
MOA
Therapeutic Use
CI
TCA
Administer 1 hr before bed time to treat enuresis in kiddos
(Less expensive than desmopressin)
-CI: Hx of CVD in family
Describe how Desmopressin and Imipramine are administered to treat enuresis in children
Discontinue every two weeks, reassess need. Reassess again at three mos.
NT change seen in ADHD?
Main goal of pharmacologic therapy?
decreased DA/ NE in orbitofrontal, prefrontal, cingulate gyrus
goal: increase DA/ NE
Oppositional Defiant Disorder is commonly comorbid with what condition?
It involves malfunction with what cortical area?
- comorbid w/ ADHD
- limbic system malfunction
Large risk assc with lithium use?
diabetes insipidus
