section name header

Pronunciation ⬇

dex-troe-am-FET-a-meen

Classifications ⬆ ⬇

Therapeutic Classification: central nervous system stimulants

Pharmacologic Classification: amphetamines

Indications ⬆ ⬇

REMS


Action ⬆ ⬇

  • Produces CNS stimulation by releasing norepinephrine from nerve endings. Pharmacologic effects:
    • CNS and respiratory stimulation,
    • vasoconstriction,
    • mydriasis (pupillary dilation),
    • Contraction of the urinary bladder sphincter.
Therapeutic effects:
  • Increased attention span in ADHD.
  • Increased motor activity and mental alertness and decreased fatigue in narcoleptic patients.

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following oral administration. 90% absorbed following transdermal administration.

Distribution: Widely distributed; high concentrations in brain and CSF. Crosses the placenta; enters breast milk.

Metabolism/Excretion: Some metabolism by the liver. Urinary excretion is pH-dependent. Alkaline urine promotes reabsorption and prolongs action.

Half-Life: PO: 10–12 hr (6.8 hr in children); Transdermal: 6–12 hr.

Time/Action Profile ⬆ ⬇

(CNS stimulation)

ROUTEONSETPEAKDURATION
PO1–2 hr3 hr2–10 hr
PO-ERunknownunknownup to 24 hr
TD1–2 hr3 hr9–12 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: palpitations, tachycardia, MI, arrhythmias, hypertension, peripheral vasculopathy, SUDDEN DEATH

Derm: allergic contact dermatitis (transdermal), alopecia, erythema (transdermal), pruritus (transdermal), STEVENS-JOHNSON SYNDROME, urticaria

GI: anorexia, constipation, cramps, diarrhea, dry mouth, intestinal ischemia, metallic taste, nausea, vomiting

GU: ↓libido, erectile dysfunction, priapism

MS: RHABDOMYOLYSIS

Neuro: hyperactivity, insomnia, restlessness, tremor, behavioral disturbances, depression, dizziness, hallucinations, headache, irritability, mania, paresthesia, STROKE, thought disorder

Misc: hypersensitivity reactions (including anaphylaxis and angioedema), physical dependence, psychological dependence

Interactions ⬆ ⬇

Drug-drug:

Drug-Natural Products:

Route/Dosage ⬆ ⬇

Attention-Deficit Hyperactivity Disorder

Renal Impairment

Narcolepsy

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Dexedrine, Xelstrym

Contr. Subst. Schedule ⬆ ⬇

Schedule II (C-II)

Code ⬆

NDC Code