psychostimulants "key points"

Question 1

stimulant medications are most commonly used as therapeutic options for

Answer 1

1) ADHD (amphetamines, methylphenidate)
- atomoxetine is a nonstimulant used for ADHD too

2) excessive sleepiness (caffeine, modafanil)
3) weight loss (phentermine)

Question 2

MOA of caffeine

Answer 2

inhibits adenosine activity

Question 3

MOA of amphetamines

Answer 3

increase catecholamine release,

modified catecholamine transport

Question 4

which drugs act using modified catecholamine transport?

Answer 4

amphetamines (ADHD),
methylphenidate (ADHD),
modafanil (xs sleepiness),
phentermine (weight loss)

Question 5

why do some stimulants have addictive properties?

Answer 5

have the ability to increase dopamine in reward centers of brain (not the intended/main site of action)

Question 6

what are the main catecholamine targets of stimulants?

Answer 6

dopamine
norepinephrine
serotonin (sometimes)

Question 7

three most prominent types of side effects of stimulants?

Answer 7

1) CNS activation
- insomnia
- increased irritibility/agitation

2) anorexia
- appetite suppression in hypothalamus

3) cardiovascular
- elevated BP
- due to NE related increases in peripheral vascular resistance

Question 8

order of pharmalogical treatment for ADHD based on effect size

Answer 8

1) stimulants
- methylphenidate or amphetamine based

2) other stimulant

3) strattera
- nonstimulant
- for pts with hx of substance abuse

4) wellbutrin

5) TCAs
- used before stimulants
- not used now due to side fx

6) alpha agonists
- guanfacine, clonidine
- as adjunct to stimulants
- if child too young for stimulants

Lower on list = lower effectiveness in treating ADHD