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ADHD Treatments

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turlough's version from 2017-10-30 19:12

Section 1

Question Answer
What is the brand name of atomoxetine? Strattera
What class does atomoxetine belong to? Noradrenaline Reuptake Inhibitor
What is atomoxetine licensed for? Treatment of ADHD.
2 formulations of atomoxetineCapsules and oral solution
How does atomoxetine work? Atomoxetine inhibits the presynaptic noradrenaline reuptake transporter. It isn't exactly clear how this improves ADHD symptoms.
Is atomoxetine a psychostimulant? No.
Compare and contrast atomoxetine with typical stimulant treatments for ADHD. Atomoxetine has the advantage of having no known abuse potential. However, it is not as effective as the standard stimulant treatments.
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Section 2

Question Answer
5 contraindications to the use of atomoxetine. 1) Hypersensitivity. 2) Patient is using an MAOI or has used one within the past 14 days. 3) Narrow-angle glaucoma. 4) Phaechromocytoma. 5) Severe cardiovascular or cerebrovascular disorders.
Atomoxetine is a major substrate of which hepatic enzyme? CYP2D6
Mention 3 reasons for reducing the dose of atomexetine1) Hepatic impairment. 2) Patient is a CYP2D6 poor metaboliser. 3) Patient is also using a CYP2D6 inhibitor
5 interactions with atomoxetine1) MAOIs. 2) CYP2D6 inhibitors. 3) Beta-2 agonists such as salbutamol and terbutaline. 4) Anti-hypertensive drugs. 5) Noradrenergic drugs.
List 5 CYP2D6 inhibitorsFluoxetine, paroxetine, quinine, buproprion and ritonavir.
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Section 3

Question Answer
Explain the interaction between atomoxetine and beta-2 agonistsThis combination may increase the risk of cardiovascular side effects such as tachycardia.
Explain the interaction between atomoxetine and anti-hypertensives Atomoxetine has hypertensive effects so it reduces the efficacy of these medicines
Explain the interaction between atomoxetine and noradrenergic drugs Atomoxetine inhibits noradrenaline reuptake so if it is used with a drug that increases noradrenaline levels then there is obviously a risk of excess noradrenaline and subsequent side effects.
List some drugs that affect noradrenaline levels Sympathomimetics such as pseudoephedrine, SNRIs such as venlafaxine and duloxetine and NDRIs such as buproprion and methylphenidate.
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Section 4

Question Answer
8 very common side effects of atomoxetineReduced appetite, headache, sedation (unlike stimulants), abdominal pain, nausea, vomiting, hypertension and tachycardia.
What do patients on atomoxetine and their relatives need to be told to watch out for? Unusual changes in behaviour including aggression and suicidal thoughts, particularly at the start of therapy or after any changes in dose.
What physical features should be monitored in patients on atomoxetine therapy? Weight and growth rate as atomoxetine may delay development.
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