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PHRM 845 > Stimulants and ADHD - Watts > Flashcards

Stimulants and ADHD - Watts Flashcards

1
Q

The RAS contains what 4 types of neurons?

A

DA
Adrenergic
Serotonergic
Cholinergic

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2
Q

When do symptoms of ADHD appear?

A

ages 5-9

Before 12 for diagnosis

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3
Q

How many symptoms of ADHD must be present for diagnosis?

A

6 or more

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4
Q

Symptoms of ADHD?

A

Inattention
Hyperactivity
Impulsivity

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5
Q

Inattention examples

A

Difficulty organizing tasks/activities
Does not seem to listen
Easily distracted
Loses things for activities

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6
Q

Hyperactivity examples

A

Fidgets or squirms

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7
Q

Impulsivity examples

A

Leaves seat
Runs/climbs excessively
Interrupts

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8
Q

Methylxanthines are (direct/indirect) acting sympathomimetics

A

indirect

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9
Q

3 metabolites of caffeine?

A

Paraxanthine
Theobromine
Theophylline

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10
Q

What drug class are caffeine, paraxanthine, theobromine, and theophyllin?

A

Methylxanthines

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11
Q

MOA of methylxanthines

A

Antagonize adenosine receptor
Inhibit PDE: increase cAMP
Increase activity of ryanodine receptors (increase intracellular Ca)

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12
Q

Which adenosine receptors do methylxanthines antagonize?

A

A1, A2a, A2b, and A3

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13
Q

Linked to what receptor? location in synapse and brain, and what does it do?
A1 adenosine receptor

A

Gi/o linked
Pre and post synaptic
Located in cerebral cortex, hippocampus, cerebellum, thalamus, brain stem, and spinal cord
Inhibitory modulation of many neurotransmitters

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14
Q

CNS Activation of A1 adenosine receptors

A

Sedation, neuroprotection, anxiolysis, temperature reduction, anticonvulsant activity, and spinal analgesia

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15
Q

Peripheral activation of A1 adenosine receptors

A

Bronchoconstriction, decreased glomerular filtration, decreased HR, slowed atrioventricular conduction, adn decreased atrial myocardial contractility

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16
Q

Linked to what receptor? location in synapse and brain, and what does it do?
A2a adenosine receptor

A

Gs linked
pre and post synaptic
Located in cerebral vasculature and striatum: vasodilation
Inhibitory modulation of many neurotransmitters

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17
Q

Linked to what receptor? location in synapse and brain, and what does it do?
A2b adenosine receptor

A

Heterodimerize with A1 and D2 dopamine receptors
Gs-linked
Mostly on glial cells
Function unknown

18
Q

Linked to what receptor? location in synapse and brain, and what does it do?
A3 adenosine receptor

A

Heterodimerize with A1 and D2 dopamine receptors
Gq-linked, hippocampus and thalamus
Only activated in state of excessive catabolism
NOT antagonized by methylxanthines

19
Q

Effects of methylxanthines

A 
Mild cortical arousal
Increased alertness
Decreased fatigue
Nervousness/insomnia
Ionotropic/chronotropic effects
Vasoconstriction (cerebral vessels)
Smooth muscle relaxation
Diuretic action
(think about what caffeine does!!!)
20
Q

Stimulants are (direct/indirect) acting sympathomimetics

A

indirect

21
Q

Cocaine is a ____

A

stimulant

22
Q

Cocaine is an _____ from the leaves of _____

A

alkaloid

erythroxoylon coca

23
Q

Cocaine inhibits monoamine transporters which affects the concentration of what neurotransmitters?

A

NE
5-HT
DA

24
Q

Cocaine can be used as what type of anesthetic and is highly ____ and ____

A

local

Rewarding and addictive

25
Q

Cocaine is (a direct/an indirect) acting sympathomimetics

A

an indirect

26
Q

Amphetamines are (direct/indirect) acting sympathomimetics

A

indirect

27
Q

Amphetamines are (selective/non-selective) activators of monoamines?

A

non-selective

Except MDMA which is more selective for 5-HT!

28
Q

What effects do amphetamines have on a user?

A

Wakefulness, alertness, increased ability to concentrate

29
Q

High doses of amphetamines can elicit what type of behavior?

A

Psychotic

30
Q

Clinical uses for amphetamines?

A

Narcolepsy
Anorexiant
ADHD

31
Q

Examples of pharmacologic amphetamines

A 
Dextroamphetamine
Lisdexamfetamine
Methylphenidate
Dexmethylphenidate
Adderall
Mydayis
32
Q

Which penetrates the CNS better?

Amphetamine vs Methamphetamine

A

Methamphetamine

33
Q

Non-stimulants used for ADHD

A 
Atomoxetine
TCAs
Bupropion
Clonidine
Modafinil
34
Q

Modafinil is approved for ____ but not ____

A

narcolepsy

ADHD

35
Q

Alternative therapies for ADHD?

A 
Elimination of artificial food additives, colors and/or preservatives
EEG biofeedback
Essential fatty acid supplementation
Yoga/massage
Green outdoor spaces
36
Q

Physical/cognitive aspects of narcolepsy

A 
Excessive daytime sleepiness
Cataplexy/Weakening of muscles
Poor sleep quality
Sleep paralysis
Hypnogogic hallucinations
37
Q

Treatment for narcolepsy

A 
Stimulants for sleepines
Solriamfetol
Modafinil
Antidepressants
Xyrem
Pitolisant
38
Q

Pitolisant is a (pre/post synaptic) ____ antagonist

A

presynaptic

H3 antagonist

39
Q

Solriamfetol blocks ___ and ____

A

NET and DAT

40
Q

Modafinil blocks ____

A

DAT

PHRM 845 (2 decks)

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