Amphetamine/Dextroamphetamine
- 영어발음 듣기
Trade Name
Adderall (immediate-release), Adderall XR (extended-release); generic amphetamine/dextroamphetamine, Mydayis
* 영어발음 듣기 : Amphetamine / Dextroamphetamine
Classification
Central Nervous System (CNS) stimulant; Schedule II controlled substance, ADHD Agents
Dosage/Route
- * Dosage:
- – Immediate-release (IR): 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg tablets
- – Extended-release (XR): 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg capsules
- * Route: Oral (PO)
Usual Dosage
- * ADHD (Adults): IR: 5 mg PO 1-2 times daily, increase by 5 mg/week; max 40 mg/day. XR: 20 mg PO once daily, max 60 mg/day
- * ADHD (Children ≥6): IR: 5 mg PO 1-2 times daily, increase by 5 mg/week; max 40 mg/day. XR: 5-10 mg PO daily, max 30 mg/day
- * Narcolepsy (Adults): IR: 5-60 mg/day in divided doses
- * Start low, titrate based on response; avoid late-day doses
Mechanism of Action
Increases release and blocks reuptake of dopamine and norepinephrine in the CNS, enhancing focus, attention, and wakefulness. Stimulates prefrontal cortex in ADHD; promotes alertness in narcolepsy
Side Effects & Adverse Effects
- * Side Effects: Insomnia, decreased appetite, dry mouth, nervousness, headache
- * Adverse Effects:
- – Cardiovascular: Hypertension, tachycardia, palpitations
- – Psychiatric: Agitation, psychosis, mania (high doses)
- – Dependence/abuse (Schedule II risk)
- – Growth suppression in children (long-term)
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor HR, BP at baseline and periodically (CV risk)
- – Assess weight, growth in children (appetite suppression)
- – Screen for abuse potential or psychiatric history (e.g., bipolar)
- – XR: Swallow whole; IR: Give first dose on waking
- * Teachings:
- – Take early in day (avoid PM doses to prevent insomnia)
- – Report chest pain, fast heartbeat, or mood changes
- – Avoid caffeine (worsens stimulation)
- – Don’t share med (controlled substance); store securely
- – Taper off if stopping (avoid withdrawal)
Indication for This Patient
- * Attention-Deficit/Hyperactivity Disorder (ADHD): Improves focus, reduces impulsivity (children/adults)
- * Narcolepsy: Promotes wakefulness, reduces daytime sleep attacks
Time
- * Timing:
- – IR: 1-3 times daily, first dose on waking, 4-6 hours apart
- – XR: Once daily in AM
- * Onset: IR: 30-60 min; XR: 1-2 hours
- * Peak: IR: 3 hours; XR: 7 hours
- * Duration: IR: 4-6 hours; XR: 10-12 hours
