Therapeutics - ADHD 2

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Author:
kyleannkelsey
ID:
296503
Filename:
Therapeutics - ADHD 2
Updated:
2015-02-22 14:01:48
Tags:
Therapeutics ADHD
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Therapeutics - ADHD
Description:
Therapeutics - ADHD
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  1. What are the cons of ER Stimulant formations?
    • Decreased appetite
    • Insomnia
  2. What are the ER Stimulant formations?
    • Ritalin SR, Metadate ER
    • Dexedrine Spansule
    • Concerta
    • Ritalin LA®, Adderall XR®
    • Metadate® CD
    • Daytrana®
    • Quillivant™ XR
    • Vyvanse®
  3. What are the kinetics of Ritalin SR, Metadate ER?
    • Delayed release by 60-90 minutes
    • Peak concentration at 4 hours
    • 6-8 hours of effect
    • (Do not break or crush)
  4. What are the kinetics of Dexedrine Spansule?
    5-10 hours of effect
  5. Describe the release system of Concerta?
    • OROS® delivery system (multiple drug reservoirs in a plastic capsule)
    • Back-loaded formulation
    • 22% immediate release, 78% released beginning 4 hours after ingestion
  6. What drug do you need to counsel patients on “plastic capsule in the feces”?
    Concerta
  7. Describe the release system for Ritalin LA®, Adderall XR®?
    • 50/50 beaded formulations
    • Closely mimics two doses of immediate release products
  8. Describe the release formulation for Metadate® CD?
    • 30%-70% beaded system
    • 30% now, 70% is released later
    • Mimics two doses of immediate release product
  9. What is Daytrana®?
    Transdermal methylphenidate
  10. How should Daytrana be used?
    Worn on the hip for about 9 hours
  11. What is Quillivant™ XR?
    • Extended release methylphenidate suspension
    • 5 mg/mL
    • Meant for toddlers
  12. What is Vyvanse®?
    • D-amphetamine pro-drug
    • Lysine moiety cleaved off in the GI tract
    • Can’t crush and abuse because it has to get to the GI tract to work
    • Less abuse potential
  13. What are the AE of stimulants?
    • Decreased appetite
    • Decreased growth
    • Insomnia
    • Rebound
    • SUDDEN CARDIAC DEATH
  14. What are the non-stimulant medications for ADHD?
    • Atomoxetine (Stratterra®)
    • Guanfacine (Intuniv®)
    • Modafinil (Provigil®)
    • Bupropion (Wellbutrin® SR)
    • Venlafaxine (Effexor® XR)
    • Clonidine (Catapres®)
  15. What is the brand name for Atomoxetine?
    Stratterra
  16. What is the brand name for Guanfacine?
    Intuniv
  17. What is the brand name for Modafinil?
    Provigil
  18. What is the brand name for Bupropion?
    Wellbutrin® SR
  19. What is the brand name for Venlafaxine?
    Effexor® XR
  20. What is the brand name for Clonidine?
    Catapres
  21. What is the generic name for Stratterra?
    Atomoxetine
  22. What is the generic name for Intuniv?
    Guanfacine
  23. What is the generic name for Provigil®?
    Modafinil
  24. What is the generic name for Wellbutrin® SR?
    Bupropion
  25. What is the generic name for Effexor® XR?
    Venlafaxine
  26. What is the generic name for Catapres®?
    Clonidine
  27. What is the MOA of Atomoxetine (Stratterra®)?
    • Selective norepinephrine uptake inhibitor
    • Not a stimulant
  28. What non-stimulant is First-line agent with stimulants?
    Atomoxetine (Stratterra®)
  29. What are the pros of Atomoxetine (Stratterra®)?
    • Apparent lack of abuse potential
    • Once-a-day dosing
  30. What are the Cons of using Atomoxetine (Stratterra®)?
    • Effects may not be seen for 2-4 weeks
    • Liver toxicity
    • Suicide
  31. What is the MOA of Guanfacine (Intuniv®)?
    Selective alpha-2a agonist
  32. What are the pros of Guanfacine (Intuniv®)?
    • Once-a-day dosing
    • Not controlled
  33. Can Tenex®be substituted for Guanfacine (Intuniv®) on a mg-mg basis?
    No
  34. What are the SE of Guanfacine (Intuniv®)?
    Hypotension and bradycardia (since it is a BP drug as well)
  35. What is the MOA of Modafinil (Provigil®)?
    • CNS arousal agent
    • Produces euphoric effect
  36. What is the level of controlled substance of Modafinil (Provigil®)?
    C-IV
  37. What are the pros of Modafinil (Provigil®)?
    • Low abuse potential
    • Small studies have shown benefit
    • Minimal AEs (Headache and nausea)
  38. What are the second line agents for ADHD?
    • Bupropion (Wellbutrin® SR)
    • Venlafaxine (Effexor® XR)
    • Clonidine (Catapres®)
  39. What is the MOA of Clonidine (Catapres®?
    Central alpha2 agonist
  40. When is Clonidine (Catapres®) useful?
    • Useful at night if insomnia occurs
    • Stimulant during day and this at night works well for patients with insomnia
  41. When would you use a 2nd line agent for ADHD?
    • Stimulant failures -Lack of response after titrating up until adverse effects occur to get adequate trail
    • Intolerable adverse effects
    • High risk of abuse
    • Co-morbid disorder
    • Contraindications

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