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ADHD
n/a
48
Pharmacology
Graduate
04/05/2013

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Cards

Term
CNS stimulants
principal uses
Definition
ADHD, narcolepsy
Term
Amphetamines
drug list
Definition
amphetamine, dextroamphatamine, methamphetamine, lisdexamfetamine
Term
Amphetamines
MOA
Definition
Act causing release of NE and DA, and partly by inhibiting reuptake of both.
Term
Amphetamines
CNS effects
Definition
Increase wakefulness & alertness, reduced fatigue,euphoria, talkative, increase motor activity, elevate mood, augment self-confidence and intiative, stimulate respirations, supress appetite and perception of pain.
Term
Amphetamines
CV effects
Definition
Secondary to NE. increased HR, AV conduction, and force of contraction. Vasoconstrict bl. vessels, dysrhuthmias, HTN.
Term
Amphetamines
tolerance & dependence
Definition
Regular use causes tolerance to elevation of mood, suppression of appetite, and stimulation of the heart and blood vessels. Chronic use causes physical and psychological dependence.
Term
Amphetamines
abuse
Definition
Potential for abuse because of euphoria.
Term
Amphetamines
abstinence syndrome on DC
Definition
Exhaustion, depression, prolonged sleep, excessive sleep, excessive eating, craving amphetamine
Term
Amphetamines
adverse effects
Definition
insomnia,restless, extreme loquaciousness, weight loss, CV effects, psychosis
Term
Amphetamines
toxicity
Definition
Dizzy, confused, hallucination, paranoid delusions, palpitations, dysrhythmias, HTN, convulsions, coma, cerebral hemorrhage, death
TX-chlorpromazine, phentolamine, diazepam, acidify urine
Term
methylphenidate & dexmethylphenidate
MOA
Definition
Pharmacologic actions same as amphetamines.
Promote NE and DA release and inhibit NE and DA reuptake
Term
methylphenidate & dexmethylphenidate
side effects
Definition
insomnia, reduced appetite/wt. loss, emotional lability, stomach ache, HA, rebound symptoms, irritable/jittery, dysphoric, zombi-like, tics/abnormal movement, HTN, hallucinations, growth suppression
Term
methylphenidate & dexmethylphenidate
Efficacy in tx ADHD
Definition
Improve attentiveness & academic performance, behavior, impulse control, and peer relations while decreasing aggressive behavior.
Long-term:no significant improvements
Term
methylphenidate & dexmethylphenidate
abuse
Definition
Can cause euphoria. Drug diversion
Term
methylphenidate & dexmethylphenidate
drug interactions
Definition
psychostimulants, MAOIs, theophylinne, antidepressants, anticonvulsants, coumadin
Term
methylphenidate & dexmethylphenidate
dosing/length of therapy in ADHD
Definition
Individualized. Titrate to max efficacy w/min side effects. May attempt DC at one yr intervals, but many do not outgrow disease
Term
Caffeine
sources
Definition
chocolate, dessert, soft drink, and beverages from natural products (coffe, tea cola).
Term
Caffeine
MOA
Definition
Blockade of adenosine receptors.Vasodilate periphery, vasoconstrict CNS, relax bronchial smooth muscle, diuretic, crosses placenta.
Term
Caffeine
effects
Definition
low dose-Decreases fatigue, increases capacity for prollonged intellectual exertion, dec # & duration apnea episodes, promote reg pattern breathing in neonates.Increased doses-insomnia, nervous, tremors. High dose-convulsions
Term
Provigil
use
Definition
narcolepsy, shift-work sleep disorder, sleep apnea, fatigue, depression, ADHD, jet lag, drug induced sleepiness, MS fatigue
Term
Provigil
MOA
Definition
Influence hypothalamic area of sleep-wake cycle inhibitors activit of sleep-promoting neurons, block reuptake NE
Term
Provigil
side effects
Definition
HA, nausea, nervous, diarrhea, rhinitis, increase HR & BP, euphoria, altered perception/thinking/feeling, terotogenic, Steven-Johnsons, erythema multiforme,toxic epidermal necolysis
Term
Provigil
kinetics
Definition
Goes through P450 system
Term
Nuvigil
Definition
related to Provigil-only difference is longer 1/2 life
Term
Strychrine poisoning
Definition
No medical purpose/rat poison. S/S early-pt fully conscious, stiffness in muscles of face & neck,tonic convulsions, increase reflex excitability. Late-convulsions alternate with depression episodes until death
Term
ADHD
Definition
Neuropsych disorder of childhood. Possible DA & NE implications. Start 3-7y/o and persists into adulthood. Boys>girls
Term
ADHD
characteristics in childhood
Definition
Inattention-(off task, easily distract, incompletion of tasks)
Hyperactivity-(excessive movements)
Impulsivity-(act before think,changing activities often, disorganized, impatient)
Term
ADHD
Coorelation w/development
Definition
genetics, fetal alcohol, low birth weight, head trauma, lead exposure, meningitis
Term
ADHD
management in children
Definition
1st line-stimulant drugs (2ndnonstimulants)
family therapy
parent training
cognitive therapy for child
collaboration of clinician, family, and educators
Term
ADHD
desired outcomes
Definition
-Improved relationships
-Decreased frequency in disruptive bx
-Improved quality, efficiency, and quantity of completed school work
-Increased independence in self-care and age appropriate activities
-Improved self-esteem
-Enhanced safety
Term
ADHD
comorbid conditions
Definition
Anxiety, depression, Bipolar, Tourette's, substance abuse
Term
ADHD
classroom interventions
Definition
Seated near teacher
Staff to review daily assignments
physical exercise
Term
ADHD
characteristic in adulthood
Definition
Poor concentration, stress intolerance, antisocial behavior,anger outbursts, inability to maintain routines.
Term
ADHD
consequences untreated adulthood
Definition
Job loss, divorce, driving accidents
Term
ADHD
management in adulthood
Definition
1st line-Stimulant drug
1/3 can not tolerate-nonstilmulant after failed stimulant attempt.
Combo with behavioral therapy
Term
ADHD
CNS stimulants drug therapy
list
Definition
methylphenidate, dextroamphetamine, mixed amphetamines, methylphenidate
Term
ADHD
CNS stimulants disadvantages
Definition
Have to see physician q month
Abuse potential
Responses tend to diminish after 2-3yr
Reduce NEGATIVE behavior, do not create positive behavior
Term
ADHD
non-stiumulant drugs
list
Definition
Strattera, guanfacine, clonidine
Term
Srattera
therapeutic effects
Definition
Reduces symptoms, max response takes 1-3wks
Term
Srattera
MOA
Definition
Selective inhibitor of NE reuptake, causing NE to accumulate at synapses
Term
Srattera
kinetics
Definition
metabolized in P450 system, daily or BID dose
Term
Srattera
side effects
Definition
Dyspepsia, N/V, reduced appetite, dizzy,anorexia, FATIGUE, SEDATION, somnolence, mood swings, trouble sleeping, sexual dysfunction, urinary retention, allergic reactions, suicidal thinking, appetite suppression resulting in wt. loss and growth retardation, liver injury, raise or lower BP, tachycardia
Term
Srattera
interactions
Definition
MAOI, CYP 450 drugs
Term
guanfacine
use & side effects in ADHD
Definition
Adjunct to reduce aggression
-somnolence, fatigue, reduced BP(most pronounced initial therapy), wt. gain
Term
clonidine
use & side effects in ADHD
Definition
Adjunct to reduce aggression and aide in sleep
-somnolence, fatigue, hypotension, slow HR (increased by use of othe CNS depressants), heart block, dizzy, constipation
Term
Risperdal,Zyprexa,Geodon
use & side effects in ADHD
Definition
Control severe aggression
Improve hyperactivity and impulsivity
Beneficial is concurrent ODD/bipolar
-EPS, dizzy, hepatotoxic, wt. gain, increased prolactin
Term
Haldol
use in ADHD
Definition
Short term for severe aggression
Term
Daytrana
Definition
methylphenidate patch. applied 9hr, heat increases absorption
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