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NR 546 Week 7 ADHD Medication Table Latest.

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12
Publié le
04-11-2023
Écrit en
2023/2024

NR 546 Week 7 ADHD Medication Table Latest. Drug Name (include if IR, XR, ODT, LA) Indication (include approved ages) Neurotransmitter(s) Affected Target Symptoms Short-acting, intermediate-acting or long-acting. Duration of action, peak (if noted) Notable side effects /Patient education instructions Methylphenidate (D/L) (Concerta, Ritalin) Indication (include approved ages) Attention deficit hyperactivity disorder (ADHD) in children and adults (approved ages vary based on formulation) Narcolepsy (Metadate ER, Methylin ER, Ritalin, Ritalin SR) Neurotransmitter(s) Affected dopamine, norepinephrine reuptake inhibitor and releaser (DN-RIRe) Target Symptoms Concentration, attention span Motor hyperactivity Impulsiveness Physical and mental fatigue Daytime sleepiness Depression Pharmacokinetics • Average half-life in adults is 3.5 hours (1.3–7.7 hours) • Average half-life in children is 2.5 hours (1.5–5 hours) • First-pass metabolism is not extensive with transdermal dosing, thus resulting in notably higher exposure to methylphenidate and lower exposure to metabolites as compared to oral dosing • Immediate-release formulations (Ritalin, Methylin, generic methylphenidate) have 2–4 hour Notable side effects • Insomnia, headache, exacerbation of tics, nervousness, irritability, overstimulation, tremor, dizziness Anorexia, nausea, abdominal pain, weight loss Can temporarily slow normal growth in children (controversial) Blurred vision Transdermal: application site reactions, including contact sensitization (erythema, edema, papules, vesicles) and chemical leukoderma Nobable side effects link to neurotransmitter • Increases in norepinephrine peripherally can cause autonomic side effects, including tremor, tachycardia, tachycardia, hypertension, and cardiac arrhythmias • Increases in norepinephrine and dopamine centrally can cause CNS side effects such as insomnia, agitation, psychosis, and substance abuse Patient education instructions • Use with caution in patients with any degree of hypertension, hyperthyroidism, or history of drug abuse • Children who are not growing or gaining weight should stop treatment, at least temporarily • May worsen motor and phonic tics NR 546 Week 7 ADHD Medication Table Latest. ADHD Table durations of clinical action • Sustained-release formulations such as Methylin ER, Ritalin SR, Metadate ER, and generic methylphenidate sustained-release all have approximately 4–6 hour durations of clinical action • Sustained-release Metadate CD has an early peak and an 8-hour duration of action • Sustained-release Ritalin LA also has an early peak and an 8-hour duration of action, with 2 pulses (immediate and after 4 hours) • Sustained-release Concerta trilayer tablet, orally disintegrating tablet Cotempla XRODT, Quillivant XR, and Aptensio XR have 12-hour • May worsen symptoms of thought disorder and behavioral disturbance in psychotic patients • Stimulants have a high potential for abuse and must be used with caution in anyone with a current or past history of substance abuse or alcoholism or in emotionally unstable patients ADHD Table durations of action Orally disintegrating tablet CotemplaXR-ODT has a 12- hour duration of action.

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NR 546 Week 7 ADHD Medication Table Latest.
Drug Name Indication (include Short-acting, Notable side effects /Patient education instructions
(include if IR, XR, approved ages) intermediate-acting or
ODT, LA) Neurotransmitter(s) long-acting.
Affected Duration of action, peak (if
Target Symptoms noted)
Methylphenidate Indication (include Pharmacokinetics Notable side effects
(D/L) approved ages) • Average half-life in • Insomnia, headache, exacerbation of tics,
(Concerta, Ritalin) Attention deficit adults is 3.5 hours nervousness, irritability, overstimulation,
hyperactivity disorder (1.3–7.7 hours) tremor, dizziness Anorexia, nausea, abdominal
(ADHD) in children and • Average half-life in pain, weight loss Can temporarily slow normal
adults (approved ages vary children is 2.5 growth in children (controversial) Blurred vision
based on formulation) hours (1.5–5 hours) Transdermal: application site reactions,
Narcolepsy (Metadate ER, • First-pass including contact sensitization (erythema,
Methylin ER, Ritalin, Ritalin metabolism is not edema, papules, vesicles) and chemical
SR) extensive with leukoderma
Neurotransmitter(s) transdermal Nobable side effects link to neurotransmitter
Affected dosing, thus • Increases in norepinephrine peripherally can
dopamine, norepinephrine resulting in notably cause autonomic side effects, including tremor,
reuptake inhibitor and higher exposure to tachycardia, tachycardia, hypertension, and
releaser (DN-RIRe) methylphenidate cardiac arrhythmias
Target Symptoms and lower • Increases in norepinephrine and dopamine
Concentration, attention exposure to centrally can cause CNS side effects such as
span Motor hyperactivity metabolites as insomnia, agitation, psychosis, and substance
Impulsiveness Physical and compared to oral abuse
mental fatigue Daytime dosing Patient education instructions
sleepiness Depression • Immediate-release • Use with caution in patients with any degree of
formulations hypertension, hyperthyroidism, or history of
(Ritalin, Methylin, drug abuse
generic • Children who are not growing or gaining weight
methylphenidate) should stop treatment, at least temporarily
have 2–4 hour • May worsen motor and phonic tics

, ADHD Table

durations of clinical • May worsen symptoms of thought disorder and
action behavioral disturbance in psychotic patients
• Sustained-release • Stimulants have a high potential for abuse and
formulations such must be used with caution in anyone with a
as Methylin ER, current or past history of substance abuse or
Ritalin SR, alcoholism or in emotionally unstable patients
Metadate ER, and
generic
methylphenidate
sustained-release
all have
approximately 4–6
hour durations of
clinical action
• Sustained-release
Metadate CD has
an early peak and
an 8-hour duration
of action
• Sustained-release
Ritalin LA also has
an early peak and
an 8-hour duration
of action, with 2
pulses (immediate
and after 4 hours)
• Sustained-release
Concerta trilayer
tablet, orally
disintegrating
tablet Cotempla
XRODT, Quillivant
XR, and Aptensio
XR have 12-hour

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Publié le
4 novembre 2023
Nombre de pages
12
Écrit en
2023/2024
Type
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