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Meds > Stimulants and ADHD meds > Flashcards

Stimulants and ADHD meds Flashcards

1
Q

brand name for amphetamine-dextroamphetamine/lisdexamphetamine

A

adderall

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2
Q

brand name for atomoxetine

A

strattera

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3
Q

brand name for clonidine

A

catapres

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4
Q

brand name for guanfacine

A

intuniv

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5
Q

brand name for lisdex amfetamine

A

vyvanse

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6
Q

brand name for methylphenidate

A

ritalin
concerta

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7
Q

FDA approved uses for adderall

A

ADHD
narcolepsy

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8
Q

what ADHD meds require monitoring for growth suppression

A

adderall
vyvanse

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9
Q

which ADHD meds are teratogenic

A

adderall
strattera
vyvanse
ritalin
concerta

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10
Q

contraindications for adderall

A

extreme anxiety/agitation
tics/Tourette’s
CV disease
severe HTN
glaucoma

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11
Q

is sgtrattera a stimulant

A

no

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12
Q

dosage range for strattera

A

40-100mg in am

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13
Q

contraindications for Strattera

A

pheochromocytoma
severe CV disorder
angle-closure glaucoma

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14
Q

strattera dosage adjustments for hepatic impairment

A

mod hepatic - 50% of normal dose
severe - 25% of normal dose

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15
Q

dosage for clonidine in ADHD

A

initial 0.1mg QHS
increase by 0.1mg qd
max of 0.4mg

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16
Q

off-label uses for clonidine

A

ADHD, Tourette’s, substance withdrawal, anxiety, clozapine-induced hypersalivation

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17
Q

length of taper for dc of clonidine

A

over 2-4 days or longer

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18
Q

dosage for IR guanfacine

A

1mg QHS
increase to 2mg in 3-4 weeks

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19
Q

dosage of ER guanfacine

A

1mg qd
increase by 1mg qd weekly
max 4mg

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20
Q

FDA approved uses for guanfacine

A

ADHD

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21
Q

off label uses of guanfacine

A

ODD
conduct disorder
motor tics
Tourette’s

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22
Q

dosage of vyvanse

A

intial 30mg QAM
increase by 10-20mg qd
range 30-70mg

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23
Q

FDA approved uses for vyvanse

A

ADHD
binge eating disorder

24
Q

off label uses for vyvanse

A

narcolepsy
treatment resistant depression

25
Q

contraindications to vyvanse

A

anxiety/agitation
motor tics/Tourette’s
arteriosclerosis
CV disease
severe HTN
hyperthyroid

26
Q

dosage of methylphenidate IR

A

5mg QAM, 5mg at lunch
increase by 5-10mg weekly
max 60mg qd

27
Q

labs to monitor with methylphenidate

A

periodic CBC and platelets

28
Q

contraindications for methylphenidate

A

anxiety/agitation
motor tics/Tourette’s
glaucoma
cardiac abnormalities

29
Q

why are stimulant drugs called sympathomimetics

A

they mimic effects of norepinephrine

30
Q

is atomoxetine a psychostimulant

A

no

31
Q

mechanism of action for amphetamine/dextroamphetamine and methylphenidate

A

indirectly act by causing release of catecholamines from presynaptic neurons

32
Q

monoamines associated with stimulants

A

increased release of dopamine and norepinephrine

33
Q

peak concentration/half-life of amphetamine and dextramphetamine

A

peak concentration: 2-3 hours
half-life: about 6 hours

34
Q
A
35
Q

formulations of methylphenidate

A

IR (Ritalin)
SR (Ritalin SR)
ER (Concerta)

36
Q

peak plasma/half-life of ritalin

A

peak plasma: 1-2h
half-life: 2-3h

37
Q

peak plasma/half-life of Ritalin SR

A

peak plasma 4-5h
half-life 8-10h

38
Q

peak plasma/half-life of concerta

A

peak plasma 6-8h
with 12 hour effectiveness

39
Q

formulation of lisdexamfeamine

A

dextroamphetamine coupled with amino acid L-lysine

40
Q

possible mechanism of action for modafinil

A

activate hypocretin-producing neurons and has a1-adrenergic receptor agonist properties

41
Q

most common initial medication for ADHD

A

Ritalin 5-10mg q3-4h

42
Q

when should you switch to a different class of meds in the treatment of ADHD

A

after all sympathomimetics have been tried

43
Q

alternatives to stimulants for the treatment of ADHD

A

wellbutrin
effexor
guanfacine
clonidine
TCAs

44
Q

what are the main two causes of somnolence that stimulants are prescribed for

A

night shift work and drowsiness from OSA

45
Q

stimulants decrease metabolism of which drugs

A

TCAs
antidepressants
warfarin
primidone
phenobarbital
phenytoin

46
Q

the effectiveness of what medications is decreased by stimulants

A

antihypertensives

47
Q

schedule of amphetamines

A

2

48
Q

schedule of modafinil, armodafinil, and phentermine

A

4

49
Q

what was the first nonstimulant approved for tx of ADHD

A

atomoxetine

50
Q

mechanism of action for atomoxetine

A

selective inhibition of presynaptic norepinephrine transporter

51
Q

max plasma/half-life of atomoxetine

A

max plasma: 1-2h
half-life: approx 5h

52
Q

common side effects of atomoxetine

A

abdominal discomfort, decreased appetite, sexual dysfunction, dizziness/vertigo, irritability, mood swings

53
Q

rare but severe side effect of atomoxetine

A

liver injury

54
Q

starting dose for strattera in children <70kg (154lb)

A

0.5mg/kg increased after 3 days to target of approx 1.2mg

55
Q

starting dose of strattera for patients >70kg (154lb)

A

initial 40mg increased in 3 days to target of approx. 80mg

56
Q

total daily dose of strattera in small children and adolescents

A

1.4mg/kg or 100mg, whichever is less

Meds (12 decks)

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