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Psychology Pharm-Stimulants > Stimulants > Flashcards

Stimulants Flashcards

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1
Q

ADHD is due to?

A

delayed brain maturation

esp. outer cortex compared to chronologic age

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2
Q

Do stimulants cure ADHD?

A

NOPE

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3
Q

Typical half-life? (long, medium, or short)

A

short

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4
Q

What is the difference in efficacy between drugs?

A

very little

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5
Q

What are the 4 phases of treatment?

A

1) counsel, 2) titrate, 3) maintenance, 4) termination

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6
Q

What is the counsel phase all about?

A

counsel parents on AEs, tx outcomes, dose and regimen..trial and error to find drug that works

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7
Q

What does it mean to titrate these drugs?

A

once you find a drug that works, switch to slow-release form for better regimen

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8
Q

What schedule are these drugs? (1-5)

A

2

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9
Q

AEs of stimulants?

A

appetite suppression (decreases with time), decreased sleep, wearing off (up and down with short acting), tics, depression/social withdrawal (check dosing/switch drug

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10
Q

Absolute contraindications?!

A

MAOI, psychosis, glaucoma, CV dz, hepatic dz, addictive hx

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11
Q

Amphetamines MOA?

A

release DA and NE

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12
Q

List DDI for amphetamines?

A

acetazolamide, ammonium, typical antipsychotics, dextromethorphan, digoxin, MAOI, CYP2D6

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13
Q

Acetazolamide & amphetamine DDI?

A

increase urine pH = reabsorption in kidney

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14
Q

ammonium & amphetamine DDI?

A

decrease urine pH = excretion

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15
Q

typical antipsychotics & amphetamine DDI?

A

decreases stimulant effect

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16
Q

dextromethorphan & amphetamine DDI?

A

confusion

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17
Q

digoxin & amphetamine DDI?

A

arrhythmia

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18
Q

MAOI & amphetamine DDI?

A

increased drug levels

19
Q

Amphetamine AEs?

A

abd pain, HA, insomnia, decreased appetite, anxiety, tachyC, weight loss

20
Q

Amphetamine OD and treatment?

A

mydriasis, tremor, hyperreflexia, confusion, aberrant behavior, delirium, seizures, paranoia, etc. (neuro/CV/renal/pulm/GI/muscle effects)
*Treat with benzos and supportive tx

21
Q

Atomoxetine MOA?

A

NE reuptake inhibitor

22
Q

Dexmethylphenidate and Methylphenidate MOA?

A

DA & NE reuptake inhibitors

23
Q

List DDIs for Atomoxetine, Dexmethylphenidate and Methylphenidate.

A

albuterol, epi/ergots/pseudoephedrine, MAOI, EtOH, phenytoin, CYP2D6

24
Q

Albuterol & atomoxetine/dex-/methylphenidate DDI?

A

increased CV AE

25
Q

Epi/ergots/pseudoephedrine & atomoxetine/dex-/methylphenidate DDI?

A

increased BP

26
Q

MAOI & atomoxetine/dex-/methylphenidate DDI?

A

toxicity; wait 2 weeks

27
Q

EtOH & atomoxetine/dex-/methylphenidate DDI?

A

toxic metabolites

28
Q

Phenytoin & atomoxetine/dex-/methylphenidate DDI?

A

increased blood levels of pheytoin

29
Q

Amoxetine AEs?

A

xerostomia, HA, abd pain, cough, drowsiness, N/V, insomnia, decreased appetite

30
Q

Amoxetine/dex-/methylphenidate OD?

A

neuro/CV/renal/pulm/GI/muscle effects (pretty much same as amphetamine but more mild)

31
Q

Treatment of Amoxetine/dex-/methylphenidate OD?

A

benzodiazepines and supportive tx; sedate and prevent seizures

32
Q

Methyphenidate AEs?

A

HA, insomnia, N/V, abd pain, decreased appetite (patch formation)

33
Q

What is the most common comorbidity with tics and Tourettes?

A

ADHD

34
Q

What are the DOCs for Tourettes/tic and ADHD?

A

Alpha 2 agonists

35
Q

List the alpha 2 agonists.

A

Clonidine and ganfacine

36
Q

Clonidine and guanfacine MOA? Respective areas of action?

A

POST-synaptic a2 agonist
clonidine–regulates locus ceruleus NE release
guanfacine–prefrontal cortex

37
Q

DDI for a2 agonists?

A

cyclosporine (increased drug levels), bupropion (seizure). NO CYPs

38
Q

AEs of a2 agonists?

A

dry mouth, skin rash, somnolence, HA, fatigue, anxiety, abd. pain, dizziness

39
Q

OD of a2 agonists?

A

paradoxical HTN (give nitroprusside), then hypoTN (give atropine and dopamine)

40
Q

What are the DOC for tics w/o ADHD?

A

antipsychotics (like haloperidol)

41
Q

Haloperidol MOA?

A

high potency anti-psychotic (D2 blocker)

42
Q

Haloperidol ADEs?

A

CYP2D6/3A4, Long QT

43
Q

What is 3rd line for Tourettes/tic and ADHD combo?

A

methylphenidate and alpha2 agonist combo

Psychology Pharm-Stimulants (2 decks)

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