Segars: ADHD drugs

Question 1

What are the Stimulants in ADHD medication

Answer 1

• Amphetamine, Dextroamphetamine,
• Lisdexamfetamine (pro drug)
• Methylphenidate and dexmethylphenidate

Question 2

What are the non stimulants?

Answer 2

• Atomoxetine
• Guanfacine
• Clonidine

Question 3

What isomer of amphetamine or methylphenidate has more CNS activity

Answer 3

D

Question 4

What is methylphenidate’s main activity?

Answer 4

• inhibition of DA reuptake and inhibition of neurotransmitter pre-synaptic reuptake
• Doesn’t stimulate release of neurotransmitter like amphetamine

Question 5

what are the non IR amphetamine formulations?

Answer 5

• Adzenys XR
• Dyanavel XR
• Dexedrine spansules (dextroamphetamine)
• Vyvanse (lisdexamfetamine, prodrug of dextroamphetamine)
• Adderall (amphetamine/dextroamphetamine)

Question 6

ROA of Adzenys

Answer 6

oral disintegrating tablet

Question 7

% for Adzenys

Answer 7

50 IR 50 XR

Question 8

ROA for Dyanavel

Answer 8

liquid

Question 9

ROA Dexedrine Spansules

Answer 9

sprinkle on food

Question 10

ROA of Vyvanse

Answer 10

may empty capsule contents into glass of water, juice or pudding/yogurt . . . working on chewable tablet

Question 11

ROA for Adderall XR

Answer 11

can sprinkle capsule on food

Question 12

% for Adderall XR

Answer 12

50% IR 50% XR

Question 13

What are the Non IR forms of Methylphenidate

Answer 13

• Concerta
• Ritalin LA
• Metadate CD
• Aptensio
• Daytrana
• QuilliChew ER
• Quillivant
• Focalin

Question 14

% for Concerta

Answer 14

22% IR and 78% ER

Question 15

% for Ritalin LA

Answer 15

50% IR and 50% LA

Question 16

% for Metadate

Answer 16

30% IR and 70% CD

Question 17

% for Aptensio XR

Answer 17

40% IR and 60% XR

Question 18

ROA for Daytrana

Answer 18

patch

Question 19

% for QuilliChew ER

Answer 19

30% IR and 70% XR

Question 20

ROA for QuilliChew ER

Answer 20

chewable tablet

Question 21

% for Quillivant XR

Answer 21

20% IR and 80% XR

Question 22

ROA for Quillivant XR

Answer 22

liquid

Question 23

% for Focalin

Answer 23

50% IR and 50% XR

Question 24

What are the rare side effects of stimulants needed to watch out for

Answer 24

• Sudden cardiac death
• structural cardiac abnormalities
• Always assess for cardiac structural abnormalities

Question 25

MOA of Atomoxetine

Answer 25

inhibition of NE pre synaptic reuptake . . .NET blocker

Question 26

MOA of Guanfacine and Clonidine

Answer 26

Agonist of CNS alpha-2a receptors

Question 27

onset of activity for non stimulants

Answer 27

1-4 Weeks

Question 28

brand name for Atomoxetine

Answer 28

Strattera

Question 29

Difference in side effects of Atomoxetine from stimulants

Answer 29

• No motor/vocal tics
• No seizures
• Yes suicidal ideations
• Yes severe liver injury/jaundice

Question 30

What are the cautions for using Atomoxetine?

Answer 30

• Narrow angle Glaucoma
• MAO inhibitors
• CYP2D6 inhibitors

Question 31

Brand name for Guanfacine

Answer 31

Intuniv

Question 32

Brand name for Clonidine

Answer 32

Dapvay

Question 33

What is the comment for both Guanfacine and Clonidine?

Answer 33

Downward dose titration over 1+ week

-risk of rebound Hypertension

Question 34

Side effects of Guanfacine and Clonidine

Answer 34

• Dyspepsia/GI distress
• Somnolence/Sedation/Fatigue
• Hypotension/Bradycardia: orthostatic hypotension
• Rare: Exacerbation of cardiac conduction abnormalities (QT prolongation, AV block)

Question 35

use caution with Guanfacine and Clonidine when?

Answer 35

• Symptomatic CV disease (intolerant of decrease in BP): hypotension/Bradycardia
• Cardiac conduction Abnormalities