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Drugs for ADHD

This is a disorder that manifests in early childhood with symptoms of hyepractivity, impulsivity, and/or inattention. symptoms can be cognitive, academic, behavioral, emotional, social funcitoning ADHD
what is the first line DOC CLASS for school aged children (<6 years old ) and adolescents with uncomplicated ADHD stimulants
what schedule class do stimulants fall under? schedule II
schedule II stimulants can have what types of duration for drugs? short, intermediate, and long acting
is the exact MOA for stimulants in treatment of ADHD known? no
describe the different options for drugs for ADND atomoxetine, alpha 2 adrenergic agonists, antidepressants, investigational
this is not a controlled substance, and is not scheduled Atomoxetine
list the specific drugs that can be used to treat ADHD methylphenidate, amphetamines,atomoxetine, guafacine, clonidine
this drug has multiple lengths of action. can come in short acting, or long acting, and different formulations. methylphenidate
with short acting methylphenidate, how long does it take for effects to be seen, and what is the duration 20-60 mins, duration is 3-5 hours.
list the different forms of long acting amphetamines which are available single pulse wax matrix sustained release, sustained release capsules, osmotic release tablets, oral suspension, patch
these drugs are prescribed as a single salt (dextroamephetamine or a mixed salt (dextroamphethamine-amphetamine) salts amphetamine. Also available in intermediate and long cting formulations: (intermediate acting up to six hours, longer acting up to ten hours)
what is the mechanism of action of amphetamine? blocks VMAT
what is the mechanism of action of amphetamine? blocks NET, reverses NET, blocks VMAT, reverses VMAT
what is the frequency of adverse drug reactions comparing emphetamines and methylphenidate? frequency is similar for both
which has a greater decrease in weight over time, methylphenidate or mixed salt amphetamines mixed salt amphetamines
adverse drug reactions occur more frequently in pre-school children or older children? pre-school children
list some adverse effects of amphetamines anorexia, weight loss, poor growth, slep disturbance, jitteriness, social withdrawal, development of tics, maybe CV effects.
stimulants are black boxed for what? abuse potential and drug dependence
what are some contraindications to stimulants? symptomatic CV disease, moderate to severe HTN, hyperthyroidism, known hypersensitivity or idiosyncrasy to sympathomimetic amines, motor tics and tourette syndrome, glaucoma, agitated states ,anxiety, history of drug abuse, concurrentusew/i2wks of MAOI
what is the mechanism of action of atomoxetine blocks the reuptake of NE
when is atomoxetine used? alternative to stimulants for children and adolescents when: substance abuse problems (patient or family) or severe side effects.
what is the duration of action of atomexetine? 10-12 hrs
how long does it take for atomoxetine for initial response to occur? 1-2 weeks, up to four weeks for maximal response. must be taken daily, no drug holidays
dose of atomoxetine depends on what? Patient weight
atomoxetine metabolized by what CYP enzyme? CYP2D6
list some adverse drug reactions for atomoxetine weight loss, decreased appetitie, N/V, abdominal pain, dyspepsia, headache, dizziness, somnolence, irritability, CV?, tics, liver disease?
atomexatine is black boxed for what? suicidal thinking
list some contraindications to atomexetine hypersensitivity to atomexatine or any component, concurrent use/or within 2 weeks of MAOIs, glaucoma, current/past hisotry of pheochromocytoma, severe CV disorders that elevate blood pressure or HR
extended release clonidine or extended release guanfacine are part of what drug class? alpha 2 adrenergic agonist
alpha 2 adrenergic agonists are reserved for use in which population? children/adolescents who respond poorly, have unaccpetable side effects or comorbid conditions that preclude the use of stimulant or atomoxetine. may take up to 2 weeks for initial response.
this type of clonidine formulation may be used as stimulant adjunct therapy for over-aroused, easily frustrated, highly active, or aggressive individuals. clinidine Extended release
what are some side effects for clonidine extended release? sedation, depression, bradycardia, headache, and possible hypotesion
what are some side effects of ER clonidine sedation, depression, bradycardia, headache, and possible hypotension
extended release guafacine can be used for what? ADHD or adjunct for stimulation therapy. (once daily dosing)
what are some adverse effects of alpha 2 adrenergic agonists? headache, fatigue, abdominal pain, and sedation
alpha 2 adrenergic agonists improve what conditions? ADHD and comorbid tics
what is an off label antidepressant that can be used for ADHD? dopamine reuptake inhibitors (buproprion)
how does buproprion work? blocks the reuptake of NE and Dopamine. modest efficacy in decreasing hyperactivity and aggressive behavior. a
what are some adverse effects of buproprion irritability, anorexia, insomnia, motor tics
what is another off label drug for ADHD tricyclic antidepressants: inhibits reuptake of NE and seratonin, associated with adverse CV effects and anticholinergic effects
what are the drugs for investivational treatment of ADHD donepezil, nicotinic analogues, modafanil (while useful compared to placebo, induces serious dermatologic (s-J) and psychological hallucinations.
modafinil is never used in what population? children
what is the ADHD treatment drug of choice for adults? stimulants are mainstay, but abuse potential encourages the trial of a non-stimulant first.
stimulants are more effective in adults or children? children
cognitive functions may imnprove in adults taking this drug regardless of ADHD diagnosis methylphenidate
what is an adverse drug reaction of stimulants in adults? sleep disturbances (delayed onset of sleep)-common in ADHD adults that are untreated. there can also be sudden unexplained death/CV concerns
what is the first medication approved for adults that has no risk of suicide for adults? atomoxetine
this drug class has limited data for use in adults with ADHD antidepressants (buproprion and TCAs)but they have off label use
Created by: aferdo01