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Pharm II - Week 2

ADHD drug treatment

QuestionAnswer
With prolonged use, CNS drug effects change, causing a pt. to develop _____, _____, and ____ Tolerance, cross-tolerance (to therapeutic and side effects); and withdrawal symptoms
True or false: When a pt. develops tolerance to heroin, then they will also need an increased dosage of opiates True due to cross tolerance
Aside from methamphetamines and cocaine, what are prototypes of CNS stimulants? Caffeine (methylxanthines), Ritalin (methylphenidate)
Methylphenidate is a schedule _____ drug II
How does methylxanthine and methylphenidate work? Enhance excitability of neurons by releasing NE and dopamine. Partially inhibits reuptake of these NT causing prolonged effect
Review: what is the blood brain barrier? Very tight spaced lipids on cellular membrane which only allow highly lipid-soluable, non-ionized/free drug molecules to pass through
The therapeutic effects of CNS drugs are often the result of what? The effects of our body's adaptation to the drug, not the drug's effects itself
CNS drugs are used therapeutically for... Increased alertness, weight loss, narcolepsy, enhanced involuntary functions (breathing in premies)
True or false: CNS stimulants are used to treat mood disorders False. They are not antidepressant
CNS stimulants have high _______ Abuse potential
List the side effects of methylxanthine and methylphenidate Anxiety, insomnia, euphoria, emotional lability, psychosis 9with dopamine), decreased sensitivity to pain, nervousness/tremors
Which SE of caffeine and Ritalin cause most concern? Tachycardia, increased BP, increased conduction/contraction, arrhythmias, decreased sensitivity to pain
Cafffeine is readily absorbed from _____ tract and peaks within _____ GI, 1 hour
How long does it take for caffeine to be fully excreted? >24 hours
Caffeine can increased the perception of _____ stress
List the drugs used for ADHD (generic and trade) Ritalin (methylphenidate), Adderall (amphetamine mixture)
Attention deficit hyperactivity disorder occurs mostly in ____, s/sx begining when young boys
True or false: ADHD can persist through adulthood True
List the s/sx of ADHD Inattention, hyperactivity, impulsivity, judgment issues, difficulty with task completion, difficulty with social interactions and tolerating structure
Ritalin's mechanism of action is thought to be due to its influence on multiple _____, especially _______ Neurotransmitters; dopamine
For methylphenidate, there is great ______ ______ in dose-response relationship Individual variability
What is a major problem of Ritalin/Adderall? Insomnia and growth impairment due to appetite suppression
What are other adverse effects of CNS stimulants? Which one is a late sign of toxicity? Headache (10%), bruising due to altered prothrombin. Toxicixity: lethargy
True or false: according to most recent published study, there are no serious cardiovascular events for pts. taking ADHD drugs True
Adderall and Ritalin being taken for recreational use may have serious ADE including Cardiac, psychological, emotional, legal
True or false: only methylphenidate is a schedule II drug False. Mixed amphetamine (Adderall) also one
What is the drug prototype used as non-stimulant treatment of ADHD? Strattera (atomoxetine)
True or false: strattera has no potential for abuse due to not being a controlled drug True
How does atomoxetine work? Selective reuptake inhibitor of NE
Does atomoxetine work better for adults than for children? Yes, alternative to Ritalin
An adverse effect of Strattera includes... Risk of suicide, anticholinergic effects, hypertension, mood swings
Atomoxetine does not perform as well as ______ for symptom control Stimulants
Straterra is a cateogry _____ drug C
Toxicity with atomoxetine may be caused by DDIs with medications such as ____ and ____ due to blockage of enzyme groups Prozac, Paxil
Strattera is contraindicated in people with... Glaucoma, CV risks, liver disease
Strattera should not be used with or within 2 weeks of discontinuing ______ MAOIs
Like most psychotropics, a rare but serious side effect of atomoxetine includes Liver damage
True or false: Although Strattera is given at lowest dose to achieve therapeutic level, there are many different dosage levels due to variability in pt. size and reaction to drug True
Created by: choel
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