Stimulants and ADHD - Watts

Question 1

The RAS contains what 4 types of neurons?

Answer 1

DA
Adrenergic
Serotonergic
Cholinergic

Question 2

When do symptoms of ADHD appear?

Answer 2

ages 5-9

Before 12 for diagnosis

Question 3

How many symptoms of ADHD must be present for diagnosis?

Answer 3

6 or more

Question 4

Symptoms of ADHD?

Answer 4

Inattention
Hyperactivity
Impulsivity

Question 5

Inattention examples

Answer 5

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

Question 6

Hyperactivity examples

Answer 6

Fidgets or squirms

Question 7

Impulsivity examples

Answer 7

Leaves seat
Runs/climbs excessively
Interrupts

Question 8

Methylxanthines are (direct/indirect) acting sympathomimetics

Answer 8

indirect

Question 9

3 metabolites of caffeine?

Answer 9

Paraxanthine
Theobromine
Theophylline

Question 10

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

Answer 10

Methylxanthines

Question 11

MOA of methylxanthines

Answer 11

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

Question 12

Which adenosine receptors do methylxanthines antagonize?

Answer 12

A1, A2a, A2b, and A3

Question 13

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

Answer 13

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

Question 14

CNS Activation of A1 adenosine receptors

Answer 14

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

Question 15

Peripheral activation of A1 adenosine receptors

Answer 15

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

Question 16

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

Answer 16

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

Question 17

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

Answer 17

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

Question 18

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

Answer 18

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

Question 19

Effects of methylxanthines

Answer 19

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!!!)

Question 20

Stimulants are (direct/indirect) acting sympathomimetics

Answer 20

indirect

Question 21

Cocaine is a ____

Answer 21

stimulant

Question 22

Cocaine is an _____ from the leaves of _____

Answer 22

alkaloid

erythroxoylon coca

Question 23

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

Answer 23

NE
5-HT
DA

Question 24

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

Answer 24

local

Rewarding and addictive

Question 25

Cocaine is (a direct/an indirect) acting sympathomimetics

Answer 25

an indirect

Question 26

Amphetamines are (direct/indirect) acting sympathomimetics

Answer 26

indirect

Question 27

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

Answer 27

non-selective Except MDMA which is more selective for 5-HT!

Question 28

What effects do amphetamines have on a user?

Answer 28

Wakefulness, alertness, increased ability to concentrate

Question 29

High doses of amphetamines can elicit what type of behavior?

Answer 29

Psychotic

Question 30

Clinical uses for amphetamines?

Answer 30

Narcolepsy Anorexiant ADHD

Question 31

Examples of pharmacologic amphetamines

Answer 31

``` Dextroamphetamine Lisdexamfetamine Methylphenidate Dexmethylphenidate Adderall Mydayis ```

Question 32

Which penetrates the CNS better? | Amphetamine vs Methamphetamine

Answer 32

Methamphetamine

Question 33

Non-stimulants used for ADHD

Answer 33

``` Atomoxetine TCAs Bupropion Clonidine Modafinil ```

Question 34

Modafinil is approved for ____ but not ____

Answer 34

narcolepsy | ADHD

Question 35

Alternative therapies for ADHD?

Answer 35

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

Question 36

Physical/cognitive aspects of narcolepsy

Answer 36

``` Excessive daytime sleepiness Cataplexy/Weakening of muscles Poor sleep quality Sleep paralysis Hypnogogic hallucinations ```

Question 37

Treatment for narcolepsy

Answer 37

``` Stimulants for sleepines Solriamfetol Modafinil Antidepressants Xyrem Pitolisant ```

Question 38

Pitolisant is a (pre/post synaptic) ____ antagonist

Answer 38

presynaptic | H3 antagonist

Question 39

Solriamfetol blocks ___ and ____

Answer 39

NET and DAT

Question 40

Modafinil blocks ____

Answer 40

DAT