Pharm: ADHD

Question 1

What is the MOA of the stimulants used for ADHD?

Answer 1

• Block presynaptic reuptake, interference with VMAT
• ↑ in NT release —> NE, then DA, then 5-HT each at ↑ dose

Question 2

Which isomers of AMP/MPH have more CNS activity?

Answer 2

D-isomers of AMP/MPH

Question 3

What is methylphenidate’s main activity (MOA)?

Answer 3

• Inhibition of DA reuptake and inhibition of NT pre-synaptic reuptake
• Doesn’t appear to stimulate release of NT’s

Question 4

What must you always assess for before prescribing stimulants for ADHD?

Answer 4

Structural cardiac abnormalities

Question 5

What is the onset of activity for stimulants in most patients?

Answer 5

Usually 24 hours

Question 6

What is the duration of action of the IR amphetamine-based stimulants?

Answer 6

4-6 hours

Question 7

Which IR amphetamine-based stimulant comes in a liquid form?

Answer 7

Dextroamphetamine Sulfate / ProCentra

Question 8

Which IR amphetamine-based stimulant comes in a capsule form?

Answer 8

Amphetamine Sulfate/ Evekeo

Question 9

Which XR amphetamine-based stimulant comes in a liquid form with a 13-hour duration of action?

Answer 9

Amphetamine / Dyanavel XR

Question 10

Which XR amphetamine-based stimulant comes in a capuslar form and has the longest duration (16 hrs)?

Answer 10

Amphetamine (mixed salts) / Mydayis

Question 11

What is Adzenys XR-ODT used for ADHD and who is it given to?

Answer 11

• Non-IR form of amphetamine –> 50% IR and 50% XR
• 3:1 ratio of d-amphetamine and L-amphetamine
• NO water necessary –> children 6 y/o +

Question 12

Which 2 IR methylphenidate-based stimulants used for ADHD come in a tab form; what is the their duration of action?

Answer 12

• Dexmethylphenidate / Focalin: 4-6 hours
• Methylphenidate / Ritalin: 3-4 hours

Question 13

Which IR methylphenidate-based stimulants comes in a liquid form and has a 3-4 hour duration of action?

Answer 13

Methylphenidate / Methylin Oral solution

Question 14

What are the 2 sustained-release methylphenidate-based stimulants?

Answer 14

• Methylphenidate / Ritalin-SR
• Methamphetamine / Desoxyn

Question 15

Which XR methylphenidate-based stimulant comes as a transdermal patch?

Answer 15

Methylphenidate Transdermal / Daytrana

Question 16

Which XR methylphenidate-based stimulants comes in a liquid form and has formulas with 8, 10, and 12-hours durations?

Answer 16

Methylphenidate / Quillivant XR

Question 17

Which 2 XR methylphenidate-based stimulants come in a tablet form and have a 12-hour duration of action?

Answer 17

• Methylphenidate HCL/ Concerta
• Methylphenidate ER / Contempla XR-ODT

Question 18

Which 4 XR Methylphenidate-Based stimulants come in a capsule form; which has the longest duration of action?

Answer 18

• Methylphenidate / Aptensio XR: 12 hours
• Dexmethyphenidate HCl / Focalin XR
• Methylphenidate HCl / Metadate
• Methylphenidate HCl ER / Ritalin LA

Question 19

What is the main effect (MOA) of the non-stimulants used for ADHD: Atomoxetine, Guanfacine and Clonidine?

Answer 19

• Inhibition of NE pre-synaptic reuptake: Atomoxetine
• Agonists of CNS α_2A adrenergic receptors: Guanfacine/Clonidine

Question 20

What is the onset of activity for the non-stimulants used for ADHD?

Answer 20

1-4+ weeks

Question 21

What form does Atomoxetine/Strattera come in and what is its duration of action?

Answer 21

Capsule form w/ a 24-hr duration of action

Question 22

Why should you not open the capsules of Atomoxetine?

Answer 22

Ocular irritant

Question 23

What form does Clonidine/Kapvay and Guanfacine/Intuniv come in and what is their duration of action?

Answer 23

Tablet form w/ a 12-24 hr duration

Question 24

When using the non-stimulants, Guanfacine and Clonidine, for ADHD why is it important to titrate th dose down over 1+ weeks upon discontinuation?

Answer 24

Risk of rebound HTN

Question 25

What are the 3 capsular forms of XR amphetamine-based stimulants?

Answer 25

- **Dextroamphetamine**/Adderall XR - **Dextroamphetamine**/Dexedrine - **Lisdexamfetamine**/Vynase