Question | Answer |
A disorder that manifests in early childhood with symptoms of hyperactivity, impulsivity, and/or inattention ? | * ADHD - attention deficit hyperactivity disorder |
Drug classes for ADHD ? | *Stimulants (1st line) *Atomoxetine * Alpha-2 adrenergic agonists (when first 2 are ineffective) * Antidepressants
(when all else fails) |
Drug List ? | **Methylphenidate--Amphetamines--Atomoxetine--Guafacine--Clonidine |
Methylphenidate basics ? | * MoA is unknown * Multiple lengths of actions (short-long) * multiple routs (oral and patch) *multiple t 1/2 from long with patch, to shorter with orals |
Amphetamine t 1/2 and MoA ? | * given as single salt (dextroamphetamine) or mixed salt (dextroamphetamine-amphetamine) * long-intermediate t 1/2 * MoA = ???? |
Stimulant Side Effects ? | * weight loss * side effects more common in pre-school kids *lack of sleep * jittery/tics *BLACK BOX = drug abuse/dependence |
Stimulant Contraindications ? | * in anyone that is already has overactive issues----hyperthyroidism, anxiety, drug use, tics, CV disease, HTN |
Atomoxetine MoA ? | * blocks reuptake of NE |
Atomoxetine use and t 1/2 ? | * alternate to kids or others w/drug side effects of the others, or abusing the other drugs *t 1/2 is 10-12hr and have to take daily |
Atomoxetine Side Effects ? | * BLACK BOX = suicide * possible liver disease, appetite loss, weight loss, tics |
Atomoxetine Contraindications ? | * hypersensitivity rxn to drug, pheochromocytoma current/past, use of MAOI use in 2 wks, and CV events that raise BP |
Alpha-2 Adrenergic Agonist overall purposes ? | (drugs are Clonidine and Guanfacine)---
* improve ADHD symptoms and comorbid tics * can be used as adjunct therapy to stimulants (C and G), or to treat ADHD (G) |
Antidepressant use in ADHD ? | * Dopamine Reuptake Inhibitors(bupropion) and TCADs(imipramine, nortriptyline) *Modest efficacy in decreasing hyperactivity and aggressive behavior |
Adult TmT of ADHD ? | * Stimulants - go to drug, but issue for abuse....see SNS side effects * Atomoxetine is first drug made for adults and NO suicide risk as with kid use |