Stimulants and ADHD meds

Question 1

brand name for amphetamine-dextroamphetamine/lisdexamphetamine

Answer 1

adderall

Question 2

brand name for atomoxetine

Answer 2

strattera

Question 3

brand name for clonidine

Answer 3

catapres

Question 4

brand name for guanfacine

Answer 4

intuniv

Question 5

brand name for lisdex amfetamine

Answer 5

vyvanse

Question 6

brand name for methylphenidate

Answer 6

ritalin
concerta

Question 7

FDA approved uses for adderall

Answer 7

ADHD
narcolepsy

Question 8

what ADHD meds require monitoring for growth suppression

Answer 8

adderall
vyvanse

Question 9

which ADHD meds are teratogenic

Answer 9

adderall
strattera
vyvanse
ritalin
concerta

Question 10

contraindications for adderall

Answer 10

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

Question 11

is sgtrattera a stimulant

Answer 11

no

Question 12

dosage range for strattera

Answer 12

40-100mg in am

Question 13

contraindications for Strattera

Answer 13

pheochromocytoma
severe CV disorder
angle-closure glaucoma

Question 14

strattera dosage adjustments for hepatic impairment

Answer 14

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

Question 15

dosage for clonidine in ADHD

Answer 15

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

Question 16

off-label uses for clonidine

Answer 16

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

Question 17

length of taper for dc of clonidine

Answer 17

over 2-4 days or longer

Question 18

dosage for IR guanfacine

Answer 18

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

Question 19

dosage of ER guanfacine

Answer 19

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

Question 20

FDA approved uses for guanfacine

Answer 20

ADHD

Question 21

off label uses of guanfacine

Answer 21

ODD
conduct disorder
motor tics
Tourette’s

Question 22

dosage of vyvanse

Answer 22

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

Question 23

FDA approved uses for vyvanse

Answer 23

ADHD
binge eating disorder

Question 24

off label uses for vyvanse

Answer 24

narcolepsy
treatment resistant depression

Question 25

contraindications to vyvanse

Answer 25

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

Question 26

dosage of methylphenidate IR

Answer 26

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

Question 27

labs to monitor with methylphenidate

Answer 27

periodic CBC and platelets

Question 28

contraindications for methylphenidate

Answer 28

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

Question 29

why are stimulant drugs called sympathomimetics

Answer 29

they mimic effects of norepinephrine

Question 30

is atomoxetine a psychostimulant

Answer 30

no

Question 31

mechanism of action for amphetamine/dextroamphetamine and methylphenidate

Answer 31

indirectly act by causing release of catecholamines from presynaptic neurons

Question 32

monoamines associated with stimulants

Answer 32

increased release of dopamine and norepinephrine

Question 33

peak concentration/half-life of amphetamine and dextramphetamine

Answer 33

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

Question 35

formulations of methylphenidate

Answer 35

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

Question 36

peak plasma/half-life of ritalin

Answer 36

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

Question 37

peak plasma/half-life of Ritalin SR

Answer 37

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

Question 38

peak plasma/half-life of concerta

Answer 38

peak plasma 6-8h with 12 hour effectiveness

Question 39

formulation of lisdexamfeamine

Answer 39

dextroamphetamine coupled with amino acid L-lysine

Question 40

possible mechanism of action for modafinil

Answer 40

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

Question 41

most common initial medication for ADHD

Answer 41

Ritalin 5-10mg q3-4h

Question 42

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

Answer 42

after all sympathomimetics have been tried

Question 43

alternatives to stimulants for the treatment of ADHD

Answer 43

wellbutrin effexor guanfacine clonidine TCAs

Question 44

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

Answer 44

night shift work and drowsiness from OSA

Question 45

stimulants decrease metabolism of which drugs

Answer 45

TCAs antidepressants warfarin primidone phenobarbital phenytoin

Question 46

the effectiveness of what medications is decreased by stimulants

Answer 46

antihypertensives

Question 47

schedule of amphetamines

Answer 47

2

Question 48

schedule of modafinil, armodafinil, and phentermine

Answer 48

4

Question 49

what was the first nonstimulant approved for tx of ADHD

Answer 49

atomoxetine

Question 50

mechanism of action for atomoxetine

Answer 50

selective inhibition of presynaptic norepinephrine transporter

Question 51

max plasma/half-life of atomoxetine

Answer 51

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

Question 52

common side effects of atomoxetine

Answer 52

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

Question 53

rare but severe side effect of atomoxetine

Answer 53

liver injury

Question 54

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

Answer 54

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

Question 55

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

Answer 55

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

Question 56

total daily dose of strattera in small children and adolescents

Answer 56

1.4mg/kg or 100mg, whichever is less