Pharmacology of ADHD Flashcards
ADHD medications can be divided into stimulants and non-stimulants. What are the primary drugs in the stimulant category?
Amphetamine (d, l); dextroamphetamine
Lisdexamfetamine (pro-drug)
Methylphenidate (d, l); dexmethylphenidate
ADHD medications can be divided into stimulants and non-stimulants. What are the 3 primary drugs in the non-stimulant category?
Atomoxetine
Guanfacine
Clonidine
MOA of stimulants used for ADHD
Enhance NT transmission by serving as direct and indirect non-catecholamine sympathomimetics
[block presynaptic reuptake, interfere with VMAT, and increase NT release (NE, then DA, then 5-HT at each increasing dose)]
___ isomers of AMP/MPH enhance CNS activity more than mixed or ____ isomers
__________’s main activity is inhibition of DA and other neurotransmitter reuptake, it does not appear to stimulate release of neurotransmitters
D; L
Methylphenidate
Stimulants are controlled substances, what does this mean for prescribable quantities and refills allowed?
1 month supply only
No refills
[some states allow 3 months of Rx’s; MO does allow future-dating]
What are the regulations regarding prescribable quantities and refills allowed for non-stimulants used to treat ADHD?
Non-scheduled, so refills are permitted up to 1 year time-frame
4 generic/brand-name IMMEDIATE RELEASE amphetamine-based stimulants including duration of action and available formulation
[All have duration of 4-6 hrs]
Dextroamphetamine/AMP/Adderall — TAB
Dextroamphetamine Sulfate/ProCentra — LIQ
Amphetamine Sulfate/Evekeo — CAP
Dextroamphetamine/Zenzidi — TAB
5 generic/brand-name EXTENDED RELEASE amphetamine-based stimulants including duration of action and available formulation
Dextroamphetamine/Adderall XR — 8-12 hrs; CAP
Dextroamphetamine/Dexedrine — 8-10hrs; CAP
Amphetamine/Dyanavel XR — 13 hrs; LIQ
Lisdexamfetamine/Vyvanse — 10-12 hrs; CAP
Amphetamine (Mixed Salts)/Mydayis — 16 hrs; CAP
Stimulant formulation of amphetamine that is 50% immediate release and 50% extended release
Adzenys XR-ODT (d,l-amphetamine)
[3:1 ratio of d-amphetamine and l-amphetamine isomers]
3 generic/brand-name IMMEDIATE RELEASE methylphenidate-based stimulants including duration of action and available formulation
Dexmethylphenidate/Focalin — 4-6 hrs; TAB
Methylphenidate/Methylin Oral solution — 3-4 hrs; LIQ
Methylphenidate/Ritalin — 3-4 hrs; TAB
2 generic/brand-name SUSTAINED RELEASE methylphenidate-based stimulants including duration of action and available formulation
Methylphenidate/Ritalin-SR — 4-8 hrs; TAB
Methamphetamine/Desoxyn — 4-8 hrs; TAB
9 generic/brand-name EXTENDED RELEASE methylphenidate-based stimulants including duration of action and available formulation
Methylphenidate/Aptensio XR — 12 hrs; CAP
Methylphenidate HCl/Concerta — 10-12 hrs; TAB
Methylphenidate ER/Comtempla XR ODT — 12 hrs; TAB
Methylphenidate Transdermal/Daytrana — 10-12 hrs; transdermal patch
Dexmethylphenidate HCl/Focalin XR — 6-10 hrs; CAP
Methylphenidate HCl/Metadate CD — 8-10 hrs; CAP
Methylphenidate HCl ER/Ritalin LA — 8-10 hrs; CAP
Methylphenidate HCl/Quillichew — 8 hrs; chewable tablet
Methylphenidate/Quillivant XR — 8, 10, 12; LIQ
________ = non-stimulant used to tx ADHD; MOA is to inhibit NE pre-synaptic reuptake
Atomoxetine
______ and _____ are non-stimulants used to tx ADHD that act as agonists of CNS alpha-2A adrenergic receptors
Guanfacine; clonidine
[modulates noradrenergic tone in PFC by enhanced noradrenergic input from locus coeruleus and direct postsynaptic stimulation of alpha-2A receptors located on dendritic spines of cortical pyramidal cells, thereby directly promoting functional connectivity of PFC networks]
Atomoxetine/Strattera ER has a duration of _____ hrs and is available in CAP form; it is metabolized by CYP2D6
24
