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45 Cards in this Set
- Front
- Back
methylphenidate
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CNS stimulant
short-acting- Ritalin, Methylin intermediate-acting- Ritalin SR, Methyln ER long-acting- Ritalin LA, Concerta, Daytrana |
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dexmethylphenidate
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CNS stimulant
short-acting-Focalin long-acting-Focali XR |
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dextroamphetamine
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CNS stimulant
short-acting-Dexetrine long-acting- Dexetrine spansule |
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amphetamine mixture
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CNS stimulant
short-acting- Adderall long-term-Adderall XR |
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lisdexamfetamine dimesylate
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CNS stimulant
long-acting- Vyvanse |
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CNS stimulants MOA
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raise the level of norepinepherine, serotonin, and dopamine into the CNS
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CNS stimulants USE
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ADHD
Conduct disorder |
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CNS stimulants adverse effects
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CNS stimulation, weight loss, cardivascular effects, psychotic manifestations, withdrawal reactions, hypersensitivity skin reaction to transdermal
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CNS stimulants contraindications
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substance abuse disorder, cardiovascular, severe anxiety, psychosis
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CNS stimulants Interactions
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MAOIs may cause hypertensive crisis, concurrent use of caffiene may increase CNS effects
methylphenidte inhibits metabolism of phenytoin, warfarin (Coumadin) and phenobarbital, leading to increased serum levels OTC cold meds with sympathomimetic action can increase CNS stimulant effects |
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CNS stimulants Administration
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transdermal meds- place patch on one hip daily in the morning and leave it in place no longer than 9 hr alternate hips daily
high potential for substance abuse disorder especially in adolescents |
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CNS stimulant effectiveness
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improvement of ADHD manifestations
improved ability to stay awake |
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Norepinepherine Selective reuptake inhibitor
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atomoxetine (Strattera)
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NSRI MOA:
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block reuptake of norepinepherine at synapses in the CNS, Atomoxetine is not a stimulant med
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NSRI USE
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ADHD
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NSRI adverse
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appetite suppression
GI effects suicidal ideation hepatoxicity |
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NSRI contraindications
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cardiovascular disorders
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NSRI interactions
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MAOIs may cause hypertensive crisis
paroxetine (Paxil), floexetine (Prozac), inhibit hepatic metabolizing enzymes, thereby increasing levels of atomoxetine |
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NSRI admin
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daily dose in the morning, or in two divided doses, morning and afternoon, with or without food
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NSRI effectiveness
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increase in ability to focus and complete tasks, and manage impulsitivity (ADHD manifestations)
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TCAs
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desipramine (Norpramin)
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imipramine (Tofranil)
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TCA
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clomipramine (Anafranil)
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TCA
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TCA MOA:
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block reuptake of monoamine neurotransmitters norepinepherine and serotonin in the synaptic space, thereby intensifying the effects that these neurotransmitters produce
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TCA USE
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depression, autism, ADHD, panic, school phobia, separation anxiety disorder, OCD
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TCA adverse
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orthostatic hypotension
anticholinergic effects weight gain sedation toxicity resulting in cholinergic blockade and cardiac toxicity evidenced by dysrhythmias decreased seizure threshold excessive sweating |
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TCA Interactions
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concurrent use of MAOI causes hypertension
antihistamines and other anticholinergic agents have additive anticholinergic effects block uptake of epinepherine and NE in the synaptic space, leading to decreased intensity of effects inhibit uptake of ephederine and amphetamine- leads to decreased responses of these meds alcohol, benzodiazepines, opioids and antihistamines cause additive CNS depression |
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TCA admin
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may take 1-3 weeks to experience therapeutic effects
full therapeutic effects may take 2-3 months sudden discontinuation of the meds can result in relapse |
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TCA contraindications
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seizure, diabetes, liver, kidney, and respiratory disorders
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TCA effectiveness
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improvement in mood
improved sleeping and eating habits increased interaction with peers decreased anger and compulsive behavior less hyperactivity, greater ability to pay attention |
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alpha2-adrenergic agonists
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guanfacine (Intuniv)
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clonidine (Kapvay)
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alpha adrenergic agonist
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alpha adrenergic agonists MOA
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known to activate presynaptic alpha adrenergic receptors within the brain
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alpha adrenergic agonist Uses
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ADHD
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alpha adrenergic agonists Adverse
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CNS effects, cardivascular effects, weight gain
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alpha adrenergic agonist contraindications
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clonidine is ccontraindicated for children less than 6 years old
clients who have cardiac disease |
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alpha adrenergic agonist interactions
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cns depressants can increase CNS effects
antihypertensives can worsen hypotension foods with high-fat content will increase guanfacine absorption |
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alpha adrenergic agonist administration
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abrupt discontinuation can result in rebound hypertension
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alpha adrenergic agonist effectiveness
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improvement of manifestations of ADHD, such as an increase in ability to focus and complete tasks, interact with peers, and manage impulsitivity
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antipsychotic-atypical
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risperidone (Risperdal)
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antipsychotic- atypical MOA
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block serotonin, and to a lesser degree, dopamine receptors
also block norepinepherine, histamine, and acetylcholine |
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antipsychotic- atypical Uses
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autism
conduct disorder PTSD relief of psychotic manifestations |
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antipsychotic- atypical adverse
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new onset of diabetes, or loss of glucose control in clients who have diabetes
weight gain hypercholesterolemia with increased risk for hypertension and other cardiovascular disease orthostatic hypotension anticholinergic effects agitation, dizziness, sedation, and sleep disruption mild extrapyramidial adverse effects, such as tremor |
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antipsychotics-atypical interactions
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alcohol, opioids, and antihistamines cause additive CNS depressant effects
by activating dopamine receptors, levodopa counteracts effects of antipsychotic agents TCAs amiodarone, and clarithromycin (Biaxin) prolong QT interval which increases risk of cardiac dysrhythmias barbituates and phenytoin decrease drug levels of quetiapine meds that inhibit CY3A4, such as fluconazole (Diflucan) inhibit hepatic drug metabolizing enzymes thereby increasing drug levels of aripprazole, queitiapine, and ziprasidone |
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antipsychotic-atypical effectiveness
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reduction of hyperactivity and improvement in mood
decrease in aggressiveness improvement in psychosis improvement in ability to perform ADLs improvement in ADHD manifestations |