Pharmacology Test 2 - Adhd And Dementia

Front 1

Neurochemistry of ADHD

Back 1

Decreased NE and Dopamine levels - associated with abnormalities in Dopamine transporters and receptors

Front 2

Mechanism of action of CNS stimulants

Back 2

Increases NE and dopamine levels by promoting their release and inhibiting the reuptake at the synapses.

Front 3

Recommended Order of ADHD treatments

Back 3

1. CNS stimulants
2. Strattera (Atomoxetine) - not as effective or as widely tested
3. Tricyclic antidepressants (TCA's) - not approved for treatment of ADHD, generally used for tic disorders

Front 4

CNS stimulant effects

Back 4

1. Increases vigilance and attention - short term memory (increased attention decreases motor activity and emotional lability)

Front 5

Methylphenidate (short acting, intermediate acting, long acting)

Back 5

CNS stimulants:
Short acting (Ritalin, Methylin)
Intermediate Acting (Ritalin, Metadate, Methylin ER)
Long Acting (Concerta, Metadate CD, Ritalin LA)

Front 6

Amphetamine (short acting, intermediate acting, long acting)

Back 6

CNS stimulants:
Short acting (Dexedrine, Dextrostat)
Intermediate Acting (Adderall, Dexedrine Spansule)
Lomg Acting (Adderall XR)

Front 7

Methylphenidate HCl

Back 7

CNS stimulant (Schedule II)
- Stimulates release of NE and D and inhibits reuptake, primarily in the cortex and the reticular activating centers

Front 8

Methylphenidate - Adverse Effects

Back 8

1. Growth suppression s/t appetite sppression (drug breaks)
2. Delayed sleep

Other:
1. Headache
2. Unmask or exacerbate tic disorders
3.Seizures
4. Arrhythias, angina, hypertension, sudden death
5. Overdose = psychosis (domamine excess)

Front 9

Adderall XR

Back 9

Blocks reuptake of NE and Dopamine

XR - taken daily; contains immediate and sustained release

Removed from Canadian market in 2005

Front 10

common Adderall XR side effects

Back 10

1. loss of appetite
2. Insomnia
3. Weight loss
4. Emotional lability
5. Depression

Front 11

Strattera (Amoxetine HCl)

Back 11

Selective NE reuptake inhibitor

Non-stimulant

QD or BID capsule; max. effect in 1-3 weeks

POTENTIAL FOR SEVERE LIVER INJURY!!

Front 12

Strattera Adverse Effects

Back 12

No SLUD

Can't see
Can't spit
Can't pee
Can't shit

Front 13

Tricyclic Antidepressants

Back 13

Only used if:
1. Stimulants are ineffective or not tolerated
2. Coexisting anxiety or depressive disorder
3. First choice if there is a family history of mood disorder

Front 14

Examples of TCAs

Back 14

1. Nortriptyline
2. Imipramine
3. Desipramine

Front 15

Clonidine

Back 15

Decreases excessive hyperactivity, has calming effect (does not improve inattention symptoms)

May be useful with insomnia - monitor BP

Front 16

Neurochemistry of Dementia Disorders

Back 16

Decreased ACh (neurotransmitter in the PNS) result of decreased enzyme needed for synthesis

Increased glutamate - result in overstimulation of N-Methyl - D - asparate causing increased intracellular calcium neuron degeneration and cell death

Front 17

Cholinesterase Inhibitors

Back 17

Slow progression of DAT by: 1. Prevent breakdown of ACh

Reacts with: traditional antipsychotics, TCAs, antihistimines

Front 18

Adverse effects of cholinesterase inhibitors

Back 18

1. GI effects - N, V, Diarrhea, anorexia
2. Neuro: dizziness, anorexia
3. Cholinergic - diarrhea
4. Bronchoconstriction

Front 19

N-Methyl-D-Aspartic Receptor Antagonists

Back 19

Used alone or in combination with cholinesterase inhibitors

Action: Inhibits glutamate (simple version), affects NMDA receptors which regulate calcium

Front 20

NMDA Adverse Effects

Back 20

1. Dizziness
2. Headache
3. Confusion
4. Constipation

Front 21

Pharmacological Treatments still being researched

Back 21

1. NSAIDS
2. Vitamin E
3. Ginkgo Biloba
4. Amyloid Vaccine
*Estrogen has been found in increase of developing Alzheimer's