Noonotropics

Question 1

Short-acting amphetamine
dextro-isomer of d,l-amphetamine sulfate
Immediate release formulation -> 30 min
1-2 hr peak and 4-6 hr duration of action

Answer 1

Dextroamphetamine sulfate (Dexedrine, Dextrostat)

Question 2

Short-acting amphetamine
Amphetamine salt; dextro-isomer of d,l-amphetamine (3:1)
Immediate release formulation -> 45 min
1-2 hr peak and 4-6 hr duration of action
*Significant CYP2D6 interactions; also flavin-containing monooxygenase

Answer 2

Adderall

Question 3

Short-acting amphetamine
Dextro-isomer of d,l-amphetamine
Immediate release formulations -> 45 min
2-3 hr peak and 4-5 hr duration of action

Answer 3

Methamphetamine HCl (Desoxyn)

Question 4

Long-acting amphetamine
Contains both immediate and extended release
>10 hr duration of action

Answer 4

Dextroamphetamine Spansule

Question 5

Long-acting amphetamine
Contains both immediate and extended release
Initial effects about 2 hrs; >7 hrs duration

Answer 5

Extended Amphetamine salt (Adderall XR)

Question 6

Short-acting Methylphenidate
1/5-2 hr peak; 4 hr duration of action
***dextro-isomer only; 2x as potent as methylphenidate

Answer 6

Dexmythylphenidate (Focalin)

Question 7

Mechanism of action of methylphenidates

Answer 7

NET & DAT inhibition

Question 8

Intermediate-acting methylphenidate
6-8 hr duration of action
Due to ER formation cannot be divided, crushed, or chewed

Answer 8

Ritalin, Methylin ER, and Metadate ER

Question 9

Long-acting methylphenidates

8-12 hr duration

Answer 9

Medadate, Ritalin LA, Concerta, Focalin XR, Daytrana

Question 10

Nonstimulant drug for ADHD
Selective NET inhibitor
dosed per body weight
*initial effects may take up to a week
*CI in pts with reduced CYP2D6 activity

SE?

Answer 10

Atomoxetine

SE: insomnia, increased BP; suicidal tendencies

Question 11

Nonstimulant drug for ADHD
Tricyclic antidepressant
Reuptake inhibitor of dopamine, 5HT, and NE
Not FDA approved for ADHD (but still used)

SE?

Answer 11

Bupropion (Wellbutrin)

SE: irritability, insomnia, decreased appetite and suicidal tendencies

Question 12

Sudden death is related to what in tricyclic antidepressants?

Answer 12

CYP2D6

Question 13

Used as second line treatment/monotherapy for ADHD

Answer 13

alpha agonists

Question 14

alpha 2 agonist in the brain
Used to treat HTN in adults and ADHD
Onset <1 hr and 3-6 hr duration

Answer 14

Clonidine (Catapres)

Question 15

selective alpha 2A agonist used for ADHD

onset 1-4 hr and 6-8 hr duration

Answer 15

Guanfacine (Tenex)

Question 16

SE of alpha agonists for ADHD

Answer 16

sedation, depression, dry mouth, hypotension, rebound hypertension; deaths in combo with stimulants

Question 17

first FDA approved reversible ChE inhibitor for probable AD

limited use due to hepatotoxicity

Answer 17

Tacrine (Cognex)

Question 18

Reversible ChE inhibitor approved for mild and moderate AD

100% bioavailability and 70 hr half-life

Answer 18

Donepezil (Aricept)

Question 19

ChE inhibitor; slow dissociation constant; butyrylcholinesterase
Greater activity but with higher incidence of side effects

Answer 19

Rivastigamine (Exelon)

Question 20

alkaloid-based ChE inhibitor; nicotinic rc activity

80-100% bioavailability and 7 hr half-life

Answer 20

Galantamine (Reminyl and Razadyne)

Question 21

NMDA rc; 5HT rc; can be combine with ChE inhibitor
100% bioavailability and 60-80 hr half-life

SE?

Answer 21

Memantine (Namenda and Ebixa)

SE: HA, fatigue, dizziness, vomiting, confusion, hallucination, cough, back pain, and dyspnea

Question 22

Tx of motor sxs in PD

Answer 22

Levadopa

Question 23

Tx of psychosis (advanced AD)

Answer 23

Haloperidol

Question 24

Tx of depression

Answer 24

5HT reuptake inhibitors; tricyclic antidepressants

Question 25

Tx of insomnia

Answer 25

melatonin