dextroamphetamine transdermal

Action and Spectrum

Actions and Spectrum:  

The medication falls under the category of central nervous system (CNS) stimulants. Its action involves the inhibition of norepinephrine and dopamine reuptake, which leads to increased synaptic concentrations of these neurotransmitters in the brain. This rise in neurotransmitter levels enhances the activity of the CNS, resulting in increased alertness, attention, and focus. 

The spectrum of dextroamphetamine transdermal refers to the range of effects that the medication can have on a person. Like other medications, dextroamphetamine transdermal can have both therapeutic and side effects, depending on the dose, duration of use, and individual factors such as age, weight, and overall health. 

Drug Interaction

Adverse Reaction

Frequency defined  

>10% 

Decreased appetite (12%) 

Decreased neutrophils (14%)  

1-10% 

Insomnia (8%) 

Nausea (3%) 

Heart rate increased (2%) 

Tic (2%) 

Abdominal pain (4%) 

Irritability (2%) 

Affect liability (3%) 

Blood pressure increased (2%) 

Vomiting (4%) 

Headache (6%) 

Application site reactions, discomfort (8%) 

Decreased WBCs in pediatric patients (10%) 

Black Box Warning

Black Box Warning:  

dextroamphetamine is a central nervous system stimulant that has high potential for abuse and dependence. Misuse of dextroamphetamine can lead to addiction, overdose, and death. 

To reduce the risk of abuse and dependence, dextroamphetamine should only be used as directed by a healthcare provider. Misuse of dextroamphetamine may result in serious cardiovascular adverse events, such as sudden death, stroke, and heart attack.  

Careful monitoring of patients, particularly those with a history of drug abuse or addiction, is essential during treatment with dextroamphetamine. 

Contraindication / Caution

Contraindication/Caution:  

Hypersensitivity: Patients who have a known hypersensitivity to any component of the medication should not use this drug.  

Cardiovascular disease: The utilization of this medication is not recommended for patients with severe hypertension, angina pectoris, cardiac arrhythmias, or other cardiovascular disorders.  

Glaucoma: The medication should not be used for patients with a confirmed diagnosis of glaucoma or a medical history of this condition  

Hyperthyroidism: The medication is also contraindicated in patients with hyperthyroidism or those who are taking thyroid medication.  

Agitation: Patients who are agitated or have a history of agitation may experience worsening symptoms with this drug. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology:

Drug exerts its pharmacological effects by increasing the release of dopamine, norepinephrine, and to a lesser extent, serotonin from presynaptic nerve terminals in the CNS.  

Pharmacodynamics: 

The pharmacodynamics of this drug involves the facilitation of the release of norepinephrine and dopamine from nerve terminals in the brain by promoting their uptake. This increases the synaptic concentration of these neurotransmitters and enhances their activity by stimulating the release of intracellular stores.  

MOA:  

The drug functions by hindering the reuptake of dopamine and norepinephrine into presynaptic neurons, which leads to an increase in their extracellular concentration. This increase in dopamine and norepinephrine concentration enhances their binding to postsynaptic receptors, stimulating the central nervous system (CNS). This CNS stimulation leads to improved attention span, focus, and impulse control in patients with ADHD.  

Pharmacokinetics: 

Absorption 

The transdermal delivery system of Dextroamphetamine allows for systemic absorption of the drug. When applied to unbroken skin, the medication is discharged from the delivery system and permeates through the “stratum corneum”to reach the bloodstream. 

Distribution 

The drug has a broad distribution throughout the body, with a significant attraction to the central nervous system (CNS).The drug is bound to plasma proteins, primarily albumin, and is distributed into the brain where it binds to dopamine transporters. 

Metabolism 

The metabolism of the drug takes place mainly in the liver, where it is metabolized by cytochrome P450 enzymes, specifically CYP2D6.The drug is converted into several metabolites, including dextroamphetamine sulfate, which is the primary active metabolite.  

Excretion and elimination 

The elimination half-life of this drug is approximately 10 hours. The primary route of excretion for the drug and its metabolites is through the urine, with a small amount being eliminated in the feces.The elimination of Dextroamphetamine is dependent on renal function, and dose adjustments may be necessary in patients with renal impairment. 

Adminstartion

Administration:  

The medication is delivered through transdermal administration, which involves applying a medication patch on the skin to deliver the drug into the bloodstream through the skin. 

To administer the medication, the patch should be applied to a hairless, clean, and dry area of skin on the hip. Using the palm of the hand, the patch should be pressed firmly onto the skin for approximately 30 seconds to ensure it adheres properly. 

The patch should be replaced every 9 hours, and a different area of skin should be used each time to prevent skin irritation. In addition, the patch should not be cut or trimmed, as this can affect the delivery of the medication. 

It is crucial to adhere to the dosing instructions given by the healthcare provider, as well as any other directions relating to the administration of the medication. Patients should not surpass the recommended dosage or the duration of use without first consulting their healthcare provider. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: dextroamphetamine transdermal 

Why do we use dextroamphetamine transdermal?  

The medication is delivered through a transdermal patch applied to the skin, which gradually releases the medication over a period of nine hours. Compared to oral medications, transdermal delivery systems are preferred because they offer a more controlled and consistent release of the medication, which reduces the risk of side effects associated with oral dosing.

This delivery method also provides longer-lasting symptom relief and is convenient for patients who have difficulty swallowing pills or require medication throughout the day. 

It is a stimulant medication that functions by increasing the levels of specific neurotransmitters in the brain, such as dopamine and norepinephrine. This increase in neurotransmitter availability helps to improve attention, focus, and impulse control, all of which are common symptoms of ADHD.