Segars ADHD Medications:Stimulants and Non-Stimulants Flashcards
ADHD occurs because of dysregulation of the______
prefrontal cortex
stimulants do what?
enhance neurotransmitter transmission by serving as direct and indirect noncatecholamine sympathomimetics
- Amphetamine (ODT)
- Dextroamphetamine
- Lisdexamfetamine
- Mixed Amphetamine salts (adderall)
Stimulants Amphetamines
What form of Methylphenidate comes in oral solution and a chewable tablet?
Methylin
What form of Methylphenidate comes in a patch?
Daytrana
How do you take:
Quillivant?
QuilliChew?
- oral suspension
- Chewable tablet
All stimulants are controlled substances which means what?
1 month supply only, no refills, no samples
Stimulants: Non-IR Forms
Adzenys XR-ODT. What is the ratio IR and XR?
how do you take it?
At what age can you start taking this?
50% IR/ 50 XR%
take it orally
ages 6 and older
Stimulants: Non-IR Forms
Dyanavel XR Liquid. What is the IR/XR ratio?
How do you take it?
At what age can you start?
IR/XR not given
taken in a liquid form. GOOD FOR PATIENTS THAT CANT SWALLOW
ages 6 and older
Stimulants: Non-IR Forms
Dexedrine Spansules(dextroamphetamine). What is the ratio?
How do you take it?
At what age and who uses it?
IR/XR not given
capsules
ages 6 and older as well as Narcoleptic adults
Stimulants: Non-IR Forms
Vyvanse (lisdexamfetamine, prodrug of dextroamphetamine)
how do you take it?
Who takes it?
-He wants us to know that it is a pro drug and an amphetamine stimulant product
chewable pills in the works
-binge eating adults
Stimulants: Non-IR Forms
Adderall XR (amphetamine/dextroamphetamine)
Whats the ratio?
what age group/who takes it?
50% IR/ 50% XR
kids ages 3 and up
Narcoleptic adults
Stimulants:Non-IR Forms
Concerta (methylphenidate). what is the ratio?
how do you take it?
how old to take?
22% IR/ 78% XR
capsule
ages 6 and up
Stimulants:Non-IR Forms
Ritalin LA (methylphenidate). whats the ratio?
how do you take it?
what age?
50% IR/ 50% LA
Capsule
Ages 6 and up
Stimulants: Non-IR Forms
Metadate CD (methylphenidate). whats the ratio? how do you take it?
what ages?
30% IR/ 70% CD
capsule
ages 6 and up
Stimulants: Non-IR Forms
Aptensio XR (methylphenidate). Whats the ratio?
how do you take it?
what ages?
40% IR/ 60% XR
capsule
ages 6 and up
Stimulants: Non-IR Forms
Daytrana (patch) (methylphenidate).
how do you take it?
how long do you wear it?
how long does it work?
Age?
patch
wear for 9 hours and it works for 10-12 hours
Ages 6 and up
Stimulants:Non-IR Forms
QuilliChew ER (methylphenidate). what is the ratio?
what is unique for this drug?
age group?
30% IR/ 70% ER
is the only extended-release chewable methylphenidate tablet
ages 6 and up
Stimulants:Non-IR Forms
Quillivant XR (Methylphenidate). What is the ratio?
what is unique for this drug?
age group?
20% IR/ 80% XR
only extended-release oral methylphenidate suspension
ages 6 and up
Stimulants: Non-IR Forms
Focalin XR (dexmethylphenidate). what is the ratio?
50% IR/ 50% XR
Rare side effects of stimulants?
sudden cardiac death
always asses for abnormalities first
DO you need to worry about abuse in kids/teens?
no
How do Non-Stimulants for ADHD work?
enhance NT transmission by:
- inhibition of NE presynaptic uptake (atomoxetine)
- agonists of CNS adrenergic receptors (gaunfacine/clonidine)
Atomoxetine MOA
- non-stimulant
- is a singular acting agent not dual like the amphetamines are
- inhibition of NE pre-synaptic reuptake
Gaunfacine/Clonidine MOA
-non-stimulants
a2 agonists of CNS adrenergic receptors
how long until non-stimulants work?
1-4 weeks +
Different side effects of Atomoxetine compared to stimulants
-has no motor/vocal tics or seizures
+ suicidal ideations. liver injury and jaundice
Be cautious of ______ when using atomoxetine
MOAIs
CYP2D6 inhibitors
How must you take patients off Gaunfacine/Clonidine?
downward titration over 1+ weeks
- Adzenys
- Dyanavel
- Dexedrine Spansules
- Vyvanse (lisdexamfetamine; pro-drug of dextroamphetamine)
- Adderall
Amphetamines Stimulants
- Concerta
- Ritalin
- Metadate
- Aptensio
- Daytrana
- QuilliChew
- Quillivant
- Focalin
Methylphenidates Stimulants
Legal differences between stimulants and non-stimulants?
- stimulants dont have samples. start RX month by month. eventually can give a max RX for 3 months
- non-Stimulants don’t have any of those hang ups
Atomoxetine
Guanfacine/Clonidine
Non-stimulants