OB-GYN 101
Pharmacy

Category:

• CNS Stimulant

Description:

• Amphetamine derivative (DEA schedule II)

Indications:

• Narcolepsy

• Attention deficit disorder with hyperactivitiy

Contraindications:

• Hyperthyroidism, hypertension, glaucoma, drug abuse

• Cardiovascular disease, anxiety, within 14 days of taking MAOI’s

Precautions:

• Pregnancy category C; excreted into breast milk

• Tourette syndrome, child <3 years

• (AMPHETAMINES have high abuse potential)

Adverse Reactions (Side Effects):

• CNS: addiction, agressiveness, chills, dependence, dizziness, dysphoria, headache, hyperactivity, insomnia, irritability, restlessness, stimulation, talkativeness, tremor

• CV: cardiomyopathy, decrease in heart rate, dysrhythmias, hypertension, palpitations, tachycardia

• GI: anorexia, constipation, diarrhea, dry mouth, metallic taste, weight loss

• GU: change in libido, impotence

• SKIN: urticaria

Administered orally

• Adult:            

  • Narcolepsy: PO 5-60mg daily in divided doses

• Child > 12 years: 

  • Narcolepsy: PO 10mg daily increasing by 10mg once daily at weekly intervals

    • 6-12 years: PO 5mg once daily increasing by 5mg weekly (max 60mg daily)

  • Attention Deficit Disorder: 

    • Age >6 years PO 5mg 1-2 times daily increasing by 5mg a day at weekly intervals

    • age 3-6 years PO 2.5mg daily increasing by 2.5mg per day at weekly intervals (max dose 40mg daily)

• Sustained release forms may be used for once daily dosage

Drug interactions:

• MAOI’s: severe hypertensive reactions possible

• Selegiline: severe hypertensive reactions possible

• Sodium bicarbonate: may inhibit excretion of dextroamphetamine

• Guanadrel, Guanehidine: antihypertensive effect inhibited by dextroamphetamine

Special considerations:

• Do not crush or chew the sustained release dosage forms

• Avoid OTC preparations unless approved by clinician