Pharmacology of ADHD Medications, Antibiotics, and Respiratory Drugs

Lisdexafetamine

Vyvanse

ADHD

Lisdexafetamine

ADHD, Amphetamine, CNS Stimulant. C-II

Lisdexafetamine

MOA: Dextroamphetamine prodrug that allows release of dopamine/norepinephrine

Lisdexafetamine

ADHD - 30mg qam, may titrate by 10-20mg to MAX 70mg

Methylphenidate

Brand: Ritalin, Concerta

Methylphenidate

Class: CNS Stimulant

Methylphenidate

MOA: Increases CNS activity by inhibiting reuptake of dopamine/norepinephrine

Methylphenidate

ADHD (IR) - 10-60mg/d in 2 divided doses(ER) - 20mg/d, titrate to MAX 60mg/d

Donepezil Hydrochloride

Brand: Aricept

Donepezil Hydrochloride

Class: Central Cholinesterase Inhibitor

Donepezil Hydrochloride

MOA: Reversibly inhibit AChE to enhance acetylcholine

Donepezil Hydrochloride

Alzheimer Disease - 5mg qd, titrate to MAX 10mg/d

Memantine Hydrochloride

Brand: Namenda

Memantine Hydrochloride

Class: NMDA Receptor Antagonist

Memantine Hydrochloride

MOA: Uncompetitive NMDA receptor antagonist

Memantine Hydrochloride

Alzheimer Disease - (IR) - 5mg qd, titrate to 10mg bid(ER) - 7mg qd, titrate to 28mg qd

Fluticasone Propionate

Brand: Flonase

Fluticasone Propionate

Class: Intranasal Adrenal Glucocorticosteroid

Fluticasone Propionate

MOA: Anti-inflammatory, antipruitic and vasoconstrictive properties

Fluticasone Propionate

Allergic/Nonallergic Rhinitis - 2 sprays/nostril per day

Montelukast Sodium

Brand: Singulair

Montelukast Sodium

Class: Leukotriene Receptor Antagonist

Montelukast Sodium

MOA: Binds to leukotriene receptors to stop physiological effects

Montelukast Sodium

Asthma - 10mg qd

Amoxicillin Trihydrate

Brand: Amoxil, Moxatag

Amoxicillin Trihydrate

Class: Beta-Lactam Antibiotic

Amoxicillin Trihydrate

MOA: Inhibits bacterial cell wall biosynthesis

Amoxicillin Trihydrate

Bacterial endocarditis, prophylaxis: Adults, 2 g po 1 h before procedure; max 2 g daily

Lyme disease: 500 mg po tid × 14-28 d

Amoxicillin with Clavulanate Potassium

Brand: Augmentin (XR)

Amoxicillin with Clavulanate Potassium

Class: Beta-Lactam Antibiotic

Amoxicillin with Clavulanate Potassium

MOA: Amoxicillin inhibits bacterial cell wall biosynthesis; Clavulanate prevents degradation of amoxicillin by B-lactamases

Amoxicillin with Clavulanate Potassium

Acute Otitis Media - 500-875mg q12h x10d

Community Pneumonia - 500mg tid OR 875mg bid x 5d

Lower Resp. Infeciton - 1g tid x 10d

Azithromycin Dihydrate

Brand: Zithromax, Z-pak

Azithromycin Dihydrate

Class: Macrolide Antibiotic

Azithromycin Dihydrate

MOA: Binds to 50s ribosome to prevent microbial protein synthesis

Azithromycin Dihydrate

Acute COPD Exacerbation - 500mg on Day 1, then 250mg Day 2-5

Bacterial Sinusitis - 500mg qd x 3d

Cephalexin Monohydrate

Brand: Keflex, Daxbia

Cephalexin Monohydrate

Class: First-generation Cephalosporin

Cephalexin Monohydrate

MOA: Inhibits bacterial wall synthesis by binding to PBP

Cephalexin Monohydrate

Skin/Tissue Infection - 500mg q12h

Osteomyelitis - 250-1000mg q6h

Otitis Media, Resp, Infection, UTI - 250-1000mg q6h

Doxycycline Hyclate

Brand: Vibramycin, Doxy100

Doxycycline Hyclate

Class: Tetracycline Antibiotic

Doxycycline Hyclate

MOA: Broad-spec antibiotic that inhibits protein synthesis at 30s ribosomal subunit

Doxycycline Hyclate

Acinetobacter Infection - 100mg q12h x 1d, then 100mg qd

Acne Vulgaris - 100mg q12h x 1d, then 100mg qd OR bid

Nitrofurantoin

Brand: Macrobid, Macrodantin

Nitrofurantoin

Class: Nitrofuran Antibiotic

Nitrofurantoin

MOA: Inactivates bacterial ribosome; bactericidal in urine

Nitrofurantoin

UTI - 100mg bid x 5-7dUTI (prophylaxis) - 100mg hs

Levofloxacin

Brand: Levaquin

Levofloxacin

Class: Fluoroquinolone Antibiotic

Levofloxacin

MOA: Inhibits bacterial DNA gyrase

Levofloxacin

Bacterial Prostatitis - 500mg qd x 28d

Bacterial Sinusitis - 750mg qd x 7d

Bronchitis - 500mg qd x 7d

Trimethoprim/Sulfamethoxazole

Brand: Bactrim, Septra

Trimethoprim/Sulfamethoxazole

Class: Sulfonamide Antibiotic

Trimethoprim/Sulfamethoxazole

MOA: SMZ inhibits dihydropteroic acid, TMP inhibits reduction of dihydrofolic acid

Trimethoprim/Sulfamethoxazole

Acute COPD Exacerbation - 800/160mg q12h x 3-7dHIV

Infection Treatment - 1600/320mg bid x 21d

HIV Infection Prophylaxis - 800/160mg qd

Celecoxib

Brand: Celebrex

Celecoxib

Class: Cyclooxygenase-2 (COX2) Inhibitor

Celecoxib

MOA: Inhibits COX2 enzyme

Celecoxib

Osteoarthritis - 100mg bid OR 200mg qd

Rheumatoid Arthritis - 100-200mg bid

Diclofenac Sodium

Brand: Voltaren

Diclofenac Sodium

Class: NSAID

Diclofenac Sodium

MOA: Nonselective COX1/COX2 inhibitor

Diclofenac Sodium

Pain - 18-50mg tid

Dysmenorrhea - 50mg tid

Meloxicam

Brand: Mobic

Meloxicam

Class: NSAID

Meloxicam

MOA: has antipyretic, analgesic, anti-inflam properting

Meloxicam

Osteoarthritis/Rheumatoid Arthritis - 7.5mg qd, titrate to MAX 15mg/d

Aripiprazole

Brand: Abilify

Aripiprazole

Class: Antipsychotic

Aripiprazole

MOA: Exhibit partial agonist activity to dopamine/serotonin receptors and anatagonist active to 5HT-2A

Aripiprazole

Bipolar Disorder - 10-15mg qd, titrate to 15-30mg

Schizophrenia - 10-15mg qd, titrate to MAX 30mg/d

Risperidone

Brand: Risperdal

Risperidone

Class: Antipsychotic, Benzisoxale

Risperidone

MOA: Potent serotonin antagonist + weaker dopamine antagonist

Risperidone

Acute episodes of BPD - 2-3mg qd, may titrate to 6mg/d

Schizophrenia - 1mg bid, may titrate to 18mg/d

Quetiapine Fumerate

Brand: Seroquel

Quetiapine Fumerate

Class: Atypical Antipsychotic

Quetiapine Fumerate

MOA: Antagonizes dopamine, serotonin, histamine and adrenergic receptors

Quetiapine Fumerate

Bipolar Disorder/Schizophrenia (Initiation) - 50mg bid, titrate to 800mg

Bipolar Disorder/Schizophrenia (Maintain) - 400-800mg/d

Major Depressive Disorder- 50mg hs, MAX 300mg/d

Alprazolam

Brand: Xanax

Alprazolam

Class: Benzodiazepine, Short or Intermediate Acting. C-IV

Alprazolam

MOA: Enhances postsynaptic effect of GABA

Alprazolam

Anxiety - 0.25-0.5mg tid, MAX 4mg/d

Panic Disorder - 0.5mg tid

Buspirone

Brand: Buspar

Buspirone

Class: Antianxiety

Buspirone

MOA: Selective 5-HT receptor partial agonist. Unlike benzodiazepines, it lacks amnestic, anticonvulsant, muscle relaxant, and hypnotic effects.

Buspirone

Anxiety - 5mg bid-tid, titrate to 20-30mg in divided doses (MAX 60mg/d)

Clonazepam

Brand: Klonopin

Clonazepam

Class: Benzodiazepine, C-IV

Clonazepam

MOA: Enhances postsynaptic effect of GABA, γ-aminobutyric acid

Clonazepam

Seizures - 2-8mg/d in divided doses, MAX 20mg/d

Diazepam

Brand: Valium

Diazepam

Class: Benzodiazepine, C-IV

Diazepam

MOA: Enhances postsynaptic effect of GABA, γ-aminobutyric acid

Diazepam

Substance Withdrawal Syndrome - 10mg tid-qd on first 24h, then 5mg tid-qid prn

Anxiety - 2-10mg bid-qid

Seizures - 2-10mg bid-qid

Lorazepam

Brand: Ativan

Lorazepam

Class: Benzodiazepine, Short or Intermediate Acting. C-IV

Lorazepam

MOA: Enhances postsynaptic effect of GABA

Lorazepam

Anxiety - 1mg bid-tid

Insomnia - 2-4mg hs