Quiz 1 Drugs Flashcards
What do psychomotor stimulants target in their MoA?
Monoamine transporters (i.e. NE, DA, 5-HT)
What are the 3 main clinical uses for psychomotor stimulants?
-Narcolepsy & other sleep disorders
-ADHD
-Obesity
What are the significant local and CNS effects of cocaine? What three elements of MoA contribute to its effects? What is it clinically used for?
What is the ADME (absorption) of cocaine? Be familiar with AE and toxicity as it relates to MoA
What are the main effects of and MoA of amphetamines?
Structural similarity can compete with monoamines for NET reuptake -> longer time in synapse
They also block VMAT, making monoamines free floating in nerve terminal and more easy to reverse transport into synapse
What are the two main clinical uses of amphetamines? Be familiar with AE and toxicity.
What leve of controlled substance are amphetamines and cocaine?
Controlled level II substances
What are the main differences in MoA between cocaine and amphetamines?
Cocaine:
-Blocks MA (i.e. DA) reuptake from synapse
Amphetamines:
-Competes with MA for reuptake
-Increases MA release into synapse
What is the difference between dextroamphetamine and amphetamine?
What is the difference between methamphetamine and amphetamine?
What four salts are combined together in Adderall?
What two categories of stimulants are used to treat ADHD?
Amphetamines
Methyphenidate
As a prodrug, what drug is lisdexamfetamine converted to after absorption? Why is it advertised as being “abuse-proof”? What benefit does it have over dextroamphetamine salts XR (Adderall XR)?
What are the main effects of methylphenidate? How does it differ from amphetamines in central/peripheral actions? What is the MoA?
*MoA is similar to cocaine
Identify the following AE of stimulants as common or uncommon/rare:
-Reduced appetite
-Hallucinations
-Dysphoria
-Weight loss
-Hypertension
-Abdominal pain
-Insomnia
-Sudden death (cardiac)
-Irritability/jitteriness
What is the cardiac BBW for stimulants? What does the AHA recommend before prescribing? What is the expected change in HR and BP for 85-95% of patients?
What is the growth BBW for stimulants in pediatric patients? What are some proposed mechanisms?
What is the FDA warning for stimulant use regarding psychological health?
What is the BBW for stimulant use regarding abuse potential?
What are the six main CI for stimulant use?
What are the two DDI for stimulant use?
1) MAOI
-MAOIs blocks breadown of monoamines; when combined with stimulants it can cause too great increase in monoamines (DA, NE, 5-HT)
2) Antihypertensives
-Stimulants may augment antihypertensive effect
What are the two stimulant options for clinical treatment? How would an appropriate option be selected?
What is the MoA of atomoxetine? How long can it take for benefits to be seen? What are 2 pros and 3 cons when compared to stimulants?
*Second pro is it is not addictive or a controlled substance
What is the MoA of clonidine? What benefits can it provide in treatment of ADHD? What are three elements of ADHD treatment it is most often used for?
AE: notable for hypotensive effects and cardiovascular risks
What is the MoA of Guanfacine? What is the duration of action compared to clonidine? What is the a2 selectivity compared to clonidine?
What is the MoA of phentermine? What is it clinically used for? Be familiar with AE and toxicity.
What is the effect of Modafinil or Armodafinil? What is the MoA as far as it is understood? What are 3 significant ways it differs from amphetamine clinically?
What level of controlled substances are modafinil and armodafinil?
Controlled level IV
What unique life-threatening AE do modafinil and armodafinil share?
What are the clinical uses for modafinil and armodafinil?
