Pharm - Stimulants Flashcards
MOA stimulants used to treat ADHD
enhance neurotransmitter transmission by serving as a direct and indirect non-catecholamine sympathomimetics
- block pre-synaptic re-uptake
- interferes with VMAT
- increase NE, DA, and 5-HT release
what is the main activity of methylphenidate when treating ADHD
blocking reuptake of dopamine and inhibiting neurotransmitter pre-synaptic reuptake
“common” side effects of stimulants
- dyspepsia/GI distress/N/V
- HA
- decreased appetite
- insomnia
- anxiety/jitteriness
- irritability/aggression/agitation
- elevated BP/HR
“rare” side effects of stimulants
- priapism (painful, persistent erection of penis)
- seizures
- sudden cardiac death
- stroke and MI
- chemical leukoderma
in what pts should you use caution when prescribing stimulants
those with:
- marked anxiety/agitation
- symptomatic CV dz
- moderate-severe HTN
- glaucoma
- motor tics/tourettes
- bipolar/psychoses
- seizures
- hx drug abuse
what is the onset of activity and supply info for stimulants
onset is 14 hours
controlled substances –> 1 month supply, no refills, no samples
what form does adderall (dextroamphetamine/AMP) come in
tablet
what form does ProCentra (dextroamphetamine sulfate) come in
liquid
what form does Evekeo (amphetamine sulfate) come in
capsule
what form does Zenzidi (dextroamphetamine) come in
tablet
list the immediate release amphetamine based stimulants used to treat ADHD
- adderall
- procentra
- evekeo
- zenzidi
list the extended release amphetamine based stimulants used to treat ADHDA
- adderall XR
- dexedrine
- dyanavel XR
- Vyvanse
- mydayis
what form does adderall XR come in
capsule
what form does dexedrine come in
capsule
what form does dyanavel XR come in
liquid
what form does Vyvanse come in
capsule
what form does Mydayis come in
capsule
what is the one liquid extended release amphetamine based stimulant
dyanavel XR
dosing and age group for adzenys XR-ODT
QD dosing
ages 6+
list the immediate release methylphenidate-based stimulants used to treat ADHD
- focalin
- methylin
- ritalin
what form does focalin come in
tablet
what form does methylin come in
liquid
what form does ritalin come in
tablet
list the sustained release methylphenidate-based stimulants used to treat ADHDA
- ritalin SR
- desoxyn
what form does ritalin SR come in
tablet
what form does desoxyn come in
tablet
list the extended release methylphenidate-based stimulants used to treat ADHD
- aptensio XR
- concerta
- comtempla XR-ODT
- daytrana
- focalin XR
- metadate CD
- ritalin LA
- quillichew
- quillivant XR
what extended release methylphenidate-based stimulants used to treat ADHD come in capsule form
- aptensio XR
- focalin XR
- metadate CD
- ritalin LA
what extended release methylphenidate-based stimulants used to treat ADHD come in tablet form
- concerta
- contempla XR-ODT
what extended release methylphenidate-based stimulants used to treat ADHD come in transdermal patch form
daytrana
what extended release methylphenidate-based stimulants used to treat ADHD come in chewable tablet form
quillichew
what extended release methylphenidate-based stimulants used to treat ADHD come in liquid form
quillivant XR
MOA non-stimulants for ADHD treatment
enhance neurotransmitter transmission via:
- inhibit NE pre-synaptic reuptake
- agonist of CNS alpha 2A adrenergic receptors
onset of activity, what patients, and schedule for non-stimulants
onset: 1-4 weeks
patients: those intolerant of stimulant effects or those resistant to using stimulants
- schedule: non-scheduled, refills and samples allowed up to 1 year
list the non-stimulant
atomoxetine/strattera ER
what form does atomoxetine/strattera ER come in
capsule
adverse effects atomoxetine/strattera ER
- nervousness
- sleep problems
- suicidal thoughts
what is atomoxetine/strattera ER metabolized by
CYP2D6
list the anti-hypertensives
- clonidine/kapvay ER
- guanfacine/intuniv ER
what forms do the anti-hypertensives come in
tablets
what is the dosing and patient age for the anti-hypertensives (guanfacine and clonidine)
what titration is necessary with these medications
every day dosing
pts 6+
downward dose titration over 1+ weeks do reduce risk of rebound hypertension
