Pharm: ADHD Flashcards
What is the MOA of the stimulants used for ADHD?
- Block presynaptic reuptake, interference with VMAT
- ↑ in NT release —> NE, then DA, then 5-HT each at ↑ dose
Which isomers of AMP/MPH have more CNS activity?
D-isomers of AMP/MPH
What is methylphenidate’s main activity (MOA)?
- Inhibition of DA reuptake and inhibition of NT pre-synaptic reuptake
- Doesn’t appear to stimulate release of NT’s
What must you always assess for before prescribing stimulants for ADHD?
Structural cardiac abnormalities
What is the onset of activity for stimulants in most patients?
Usually 24 hours
What is the duration of action of the IR amphetamine-based stimulants?
4-6 hours
Which IR amphetamine-based stimulant comes in a liquid form?
Dextroamphetamine Sulfate / ProCentra
Which IR amphetamine-based stimulant comes in a capsule form?
Amphetamine Sulfate/ Evekeo
Which XR amphetamine-based stimulant comes in a liquid form with a 13-hour duration of action?
Amphetamine / Dyanavel XR
Which XR amphetamine-based stimulant comes in a capuslar form and has the longest duration (16 hrs)?
Amphetamine (mixed salts) / Mydayis
What is Adzenys XR-ODT used for ADHD and who is it given to?
- Non-IR form of amphetamine –> 50% IR and 50% XR
- 3:1 ratio of d-amphetamine and L-amphetamine
- NO water necessary –> children 6 y/o +
Which 2 IR methylphenidate-based stimulants used for ADHD come in a tab form; what is the their duration of action?
- Dexmethylphenidate / Focalin: 4-6 hours
- Methylphenidate / Ritalin: 3-4 hours
Which IR methylphenidate-based stimulants comes in a liquid form and has a 3-4 hour duration of action?
Methylphenidate / Methylin Oral solution
What are the 2 sustained-release methylphenidate-based stimulants?
- Methylphenidate / Ritalin-SR
- Methamphetamine / Desoxyn
Which XR methylphenidate-based stimulant comes as a transdermal patch?
Methylphenidate Transdermal / Daytrana
Which XR methylphenidate-based stimulants comes in a liquid form and has formulas with 8, 10, and 12-hours durations?
Methylphenidate / Quillivant XR
Which 2 XR methylphenidate-based stimulants come in a tablet form and have a 12-hour duration of action?
- Methylphenidate HCL/ Concerta
- Methylphenidate ER / Contempla XR-ODT
Which 4 XR Methylphenidate-Based stimulants come in a capsule form; which has the longest duration of action?
- Methylphenidate / Aptensio XR: 12 hours
- Dexmethyphenidate HCl / Focalin XR
- Methylphenidate HCl / Metadate
- Methylphenidate HCl ER / Ritalin LA
What is the main effect (MOA) of the non-stimulants used for ADHD: Atomoxetine, Guanfacine and Clonidine?
- Inhibition of NE pre-synaptic reuptake: Atomoxetine
- Agonists of CNS α2A adrenergic receptors: Guanfacine/Clonidine
What is the onset of activity for the non-stimulants used for ADHD?
1-4+ weeks
What form does Atomoxetine/Strattera come in and what is its duration of action?
Capsule form w/ a 24-hr duration of action
Why should you not open the capsules of Atomoxetine?
Ocular irritant
What form does Clonidine/Kapvay and Guanfacine/Intuniv come in and what is their duration of action?
Tablet form w/ a 12-24 hr duration
When using the non-stimulants, Guanfacine and Clonidine, for ADHD why is it important to titrate th dose down over 1+ weeks upon discontinuation?
Risk of rebound HTN
What are the 3 capsular forms of XR amphetamine-based stimulants?
- Dextroamphetamine/Adderall XR
- Dextroamphetamine/Dexedrine
- Lisdexamfetamine/Vynase
