NURS660 Psychopharmacology Exam 4 - ADHD,
Dementia, Impulsivity/Compulsivity, And Addiction.
Q&A 2026
1. Cortico-striatal-thalamic loop in ADHD
Answer: Impulsivity and hyperactivity are modulated here. Motor activity, such as hyperactivity and
psychomotor agitation or retardation, can be modulated by CSTC loop from the prefrontal motor cortex
to the putamen (lateral striatum) to the thalamus and back to the prefrontal motor cortex. Common
symptoms of hyperactivity in children with ADHD include fidgeting, leaving one's seat, running/climbing,
being constantly on the go and having trouble playing quietly.
2. Mesolimbic dopamine pathway in ADHD
Answer: Too little norepinephrine or dopamine causes issues with being distracted, organized, forgetful,
or fatigued. (Norepinephrine and dopamine are the two key neurotransmitters in ADHD.)
3. Pathophysiology of ADHD
Answer: Inefficient tuning of prefrontal cortex by dysregulation of dopamine and norepinephrine.
Symptoms: inattention, hyperactivity, and impulsivity.
4. Atomoxetine (Strattera)
Answer: ADHD non-stimulant. Inhibits NET in the prefrontal cortex, increasing both DA and NE. As only a
few NET exist in the nucleus accumbens, atomoxetine does not induce an increase in DA and NE in the
nucleus accumbens, the reward center of the brain, thus atomoxetine does not have abuse potential.
Requires build-up over time, not short acting, no concern for abuse/misuse. Can't be taken with Paxil or
Wellbutrin. Adverse effects: priapism, liver injury.
5. Methylphenidate
Answer: Ritalin, Concerta, ADHD stimulant. Methylphenidate binds to the dopamine transporter and to
the norepinephrine transporter, in both cases acting as an allosteric modulator. Stops the action of the
transporters, preventing reuptake and thus allowing dopamine and norepinephrine to accumulate in the
synapse.
6. Amphetamine
, Answer: Adderall, ADHD. Competitively inhibits dopamine transporter and VMAT transporter. Blocks the
transporter for dopamine and norepinephrine. Increases dopamine at synaptic cleft. High risk for abuse.
7. Guanfacine
Answer: Intuniv, nonstimulant for ADHD. Selective agonist for alpha 2A. Better tolerated than clonidine.
8. Clonidine
Answer: Alpha 2 agonist for ADHD. Less selective than guanfacine, binds to alpha 2A, 2B, & 2C. Can
reduce signs of autonomic hyperactivity during withdrawal.
9. Lisdexamfetamine
Answer: Vyvanse, ADHD stimulant. Longer-acting, less risk for abuse. Pro-drug. Can't be snorted.
10. Impulsivity
Answer: Orbitofrontal cortex
11. Hyperactive symptoms
Answer: Prefrontal motor cortex. Declines notably by adolescence.
12. Selective attention
Answer: Dorsal ACC
13. Inattention
Answer: Inefficient information processing in DLPFC
14. Acetylcholine in Dementia
Answer: Acetylcholine is an important neurotransmitter and is thought to be involved in memory. Major
acetylcholine neurotransmitter projections originating in the basal forebrain project to the prefrontal
cortex, amygdala, and hippocampus, the primary brain structure involved in short-term memory and
most greatly affected in Alzheimer's disease.
Dementia, Impulsivity/Compulsivity, And Addiction.
Q&A 2026
1. Cortico-striatal-thalamic loop in ADHD
Answer: Impulsivity and hyperactivity are modulated here. Motor activity, such as hyperactivity and
psychomotor agitation or retardation, can be modulated by CSTC loop from the prefrontal motor cortex
to the putamen (lateral striatum) to the thalamus and back to the prefrontal motor cortex. Common
symptoms of hyperactivity in children with ADHD include fidgeting, leaving one's seat, running/climbing,
being constantly on the go and having trouble playing quietly.
2. Mesolimbic dopamine pathway in ADHD
Answer: Too little norepinephrine or dopamine causes issues with being distracted, organized, forgetful,
or fatigued. (Norepinephrine and dopamine are the two key neurotransmitters in ADHD.)
3. Pathophysiology of ADHD
Answer: Inefficient tuning of prefrontal cortex by dysregulation of dopamine and norepinephrine.
Symptoms: inattention, hyperactivity, and impulsivity.
4. Atomoxetine (Strattera)
Answer: ADHD non-stimulant. Inhibits NET in the prefrontal cortex, increasing both DA and NE. As only a
few NET exist in the nucleus accumbens, atomoxetine does not induce an increase in DA and NE in the
nucleus accumbens, the reward center of the brain, thus atomoxetine does not have abuse potential.
Requires build-up over time, not short acting, no concern for abuse/misuse. Can't be taken with Paxil or
Wellbutrin. Adverse effects: priapism, liver injury.
5. Methylphenidate
Answer: Ritalin, Concerta, ADHD stimulant. Methylphenidate binds to the dopamine transporter and to
the norepinephrine transporter, in both cases acting as an allosteric modulator. Stops the action of the
transporters, preventing reuptake and thus allowing dopamine and norepinephrine to accumulate in the
synapse.
6. Amphetamine
, Answer: Adderall, ADHD. Competitively inhibits dopamine transporter and VMAT transporter. Blocks the
transporter for dopamine and norepinephrine. Increases dopamine at synaptic cleft. High risk for abuse.
7. Guanfacine
Answer: Intuniv, nonstimulant for ADHD. Selective agonist for alpha 2A. Better tolerated than clonidine.
8. Clonidine
Answer: Alpha 2 agonist for ADHD. Less selective than guanfacine, binds to alpha 2A, 2B, & 2C. Can
reduce signs of autonomic hyperactivity during withdrawal.
9. Lisdexamfetamine
Answer: Vyvanse, ADHD stimulant. Longer-acting, less risk for abuse. Pro-drug. Can't be snorted.
10. Impulsivity
Answer: Orbitofrontal cortex
11. Hyperactive symptoms
Answer: Prefrontal motor cortex. Declines notably by adolescence.
12. Selective attention
Answer: Dorsal ACC
13. Inattention
Answer: Inefficient information processing in DLPFC
14. Acetylcholine in Dementia
Answer: Acetylcholine is an important neurotransmitter and is thought to be involved in memory. Major
acetylcholine neurotransmitter projections originating in the basal forebrain project to the prefrontal
cortex, amygdala, and hippocampus, the primary brain structure involved in short-term memory and
most greatly affected in Alzheimer's disease.
