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Drugs Dictionary: Amphetamine/Dextroamphetamine

Amphetamine/Dextroamphetamine

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

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