Ritalin
methylphenidate
Concerta
methylphenidate ER
Daytrana
methylphenidate transdermal
Focalin
dex-methylphenidate
Adderall
mixed Amphetamine
Vyvanse
lisdexamfetamine
Strattera
atomoxetine
non-stimulant
Intuniv
guanfacine
non-stimulant
Kapvay
clonidine
non-stimulant
What is the MOA of amphetamine?
stimulate NE and DA
-Stimulate more NE
What is the MOA of methylphenidate?
Blocks the reuptake of DA and NE
-block more DA
Concerta (methylphenidate ER) mimics what frequency of dosing?
TID
How are stimulates dosed?
XR-in the AM
IR- no later than 2 pm
What are the first line tx for ADHD?
Methylphenidate and amphetamine products
What is 2nd line tx for ADHD?
non-stimulant
What is 3rd line tx for ADHD?
bupropion (Wellbutrin) or TCA
How long will it take if using 3rd line tx?
up to 4 weeks
If patient is suspected of abusing drug what ADHD med can you give to him/her?
lisdexamfetamine (Vyvanse) because it is activated by the stomach acid.
What is the MOA of atomoxetine (Strattera)?
Inhibits NE reuptake CNS
Which one of the non-stimulant work the slowest?
atomoxetine (Strattera)
What are the BBW for atomoxetine (Strattera)
Suicidal thoughts and liver injury
What must you do before tx of ADHD?
Find if there is a coexisting disorder.
T/F: If there is a a coexisting disorder you should tx it first
T
What are the 3 types of ADHD?
Inattention
Hyperactive/Impulsive
Combined type
Which type of ADHD is the most common?
Combined type
What is the criteria of diagnosis of ADHD in children?
Symptoms for 6 months
6 + Symptoms
Seen impairment in 2 or more setting
What is the criteria of diagnosis of ADHD in adolescents/adults?
Symptoms for 6 months
5 + Symptoms
Seen impairment in 2 or more setting
T/F: Can use Daytrana right before pt need it to work and take it off when right before bed time.
F: Onset take 2 hr and take off 3 hr before bed
What are the common Adverse effects of stimulants?
Decrease appetite
Insomnia
Stomach Ache
Headache
Irritability
What should you monitor when placed on stimulants?
Appetite
BP
HR
Height
Weight
Which ADHD rx most benifficial in hyperactivity?
clonidine (Kapvay)
guanfacine (Intuniv)
What is the MOA of clonidine (Kapvay) and guanfacine (Intuniv)?
Inhibit NE release and increase pre-frontal cortex blood flow
What is the most common ADR of clonidine (Kapvay) and guanfacine (Intuniv)?
Sedation