Dextroamphetamine

Introduction

• Generic Name: Dextroamphetamine
• Brand Names: Dexedrine, ProCentra, Zenzedi
• Pharmacological Class: Central nervous system (CNS) stimulant
• Mechanism of Action: Increases levels of dopamine and norepinephrine in the brain, enhancing attention, focus, and control over impulses.

Indications

• Primary Use: Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children and adults.
• Other Uses: Also used to treat narcolepsy to help stay awake during the day.

Dosage

• Adults: Starting dose is usually 5 mg once or twice daily, which can be increased based on response and tolerability up to a maximum of 40 mg per day.
• Elderly: Use with caution due to the potential for more significant side effects.
• Children: For ADHD, starting at age 3, begin with 2.5 mg daily; may increase gradually. For narcolepsy, starting at age 6, doses begin similarly.

Administration

• Method: Oral intake.
• Precautions: Should be taken in the morning to prevent insomnia; avoid late evening doses.

Forms Available

• Tablets: 5 mg, 10 mg, 15 mg
• Capsules (Extended-Release): 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg
• Liquid: 5 mg per 5 mL

Side Effects

• Common: Loss of appetite, insomnia, weight loss, increased heart rate.
• Less Common: Dry mouth, headache, jitteriness.
• Rare but Serious: Cardiac issues, psychiatric disorders like paranoia or mania, long-term growth suppression in children.

Warnings

• Substance Abuse: High potential for abuse and dependence; classified as a Schedule II controlled substance.
• Contraindications: Known hypersensitivity to sympathomimetic amines, advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension.

Precautions

• General: Monitor growth in children and mental health in all patients.
• Health Conditions: Caution in patients with a history of drug dependence or alcoholism.

Interactions

• Medications: Avoid concomitant use with MAO inhibitors, certain antidepressants, and antihypertensive medications.
• Food: Acidic foods can reduce absorption; avoid large amounts of citrus or vitamin C around dose times.

Monitoring Parameters

• Blood Pressure and Heart Rate: Regular checks are necessary.
• Growth in Children: Monitor height and weight periodically.
• Mental Health: Assess for new or worsening psychiatric symptoms.

Use in Children

• Guidelines: Approved for use in children over 3 years old for ADHD.
• Monitoring: Essential to monitor side effects, especially growth suppression and mental health changes.

Use in Pregnancy

• FDA Category: C. Potential risks should be weighed against potential benefits; not recommended unless necessary.

Use in Elderly

• Recommendations: Typically not recommended due to higher cardiovascular risks and other potential side effects.

Use in Kidney Disease

• Adjustments: May require lower doses; monitor closely due to potential for decreased clearance.

Use in Liver Disease

• Caution: Use with caution; may require dose adjustments depending on the extent of liver impairment.

Patient Counselling Points

• Medication Use: Adherence to prescribed doses is crucial; do not adjust dosage without consulting a healthcare provider.
• Side Effects: Immediate reporting of cardiac symptoms or signs of psychological changes is essential.
• Lifestyle: Dietary recommendations to avoid certain foods that may interact with the drug’s effectiveness.

Table of Brand Names, Manufacturer, and Prices in USD

Brand Name	Manufacturer	Strength/Dosage Form	Price (USD)
Dexedrine	Amedra	10 mg Tablet	$2.80
Zenzedi	Arbor	30 mg Tablet	$4.00
ProCentra	Takeda	5 mg/5 mL Liquid	$5.00

15 FAQs with Answers

1. What is Dextroamphetamine used for? – Primarily to treat ADHD and narcolepsy.
2. Can Dextroamphetamine cause addiction? – Yes, it has a high potential for abuse and dependence.
3. How should Dextroamphetamine be taken? – Take orally, in the morning to avoid insomnia; follow the exact prescription.
4. What are the common side effects of Dextroamphetamine? – Includes insomnia, weight loss, and increased heart rate.
5. Is Dextroamphetamine safe during pregnancy? – Category C, generally not recommended unless clearly needed.
6. Can Dextroamphetamine be taken with alcohol? – Alcohol can increase the risk of side effects; it’s best avoided.
7. What does Dextroamphetamine interact with? – MAO inhibitors and certain antihypertensive drugs can cause dangerous interactions.
8. What should I avoid while taking Dextroamphetamine? – Avoid acidic foods and beverages which can impact drug absorption.
9. What are signs of a Dextroamphetamine overdose? – Symptoms may include rapid breathing, confusion, fever, and restlessness.
10. Is Dextroamphetamine addictive? – Yes, it is classified as a Schedule II controlled substance due to its potential for abuse.
11. Should I stop taking Dextroamphetamine suddenly? – Discontinuation should be supervised by a healthcare provider to manage withdrawal symptoms.
12. What are the rare but serious side effects of Dextroamphetamine? – Includes severe cardiac complications and psychiatric disorders.
13. What other medications interact with Dextroamphetamine? – Certain antidepressants and antihypertensive medications can have significant interactions.
14. Who should not take Dextroamphetamine? – Individuals with severe cardiovascular disease, hypertension, or a history of substance abuse.
15. How does Dextroamphetamine work to treat ADHD? – It increases neurotransmitter activity in the brain, improving attention and reducing impulsivity.