Dextroamphetamine chemical structure
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Dexamfetamine

Dextroamphetamine (also known as dextroamphetamine sulfate, dexamphetamine, Dexedrine, Dextrostat, Dexampex, Ferndex, Oxydess II, Robese, Spancap #1, and, informally, Dex), a stereoisomer of amphetamine, is an indirect-acting stimulant that releases norepinephrine from nerve terminals, thus promoting nerve impulse transmission. It increases motor activity and mental alertness, and reduces drowsiness and a sense of fatigue. more...

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Clinical uses

Its only accepted indications are for children and adults with attention deficit hyperactivity disorder (ADHD) or well-established narcolepsy, generally where non-pharmacological measures have proved insufficient. In some localities it has replaced Ritalin as the first-choice pharmacological treatment of ADHD, of which it is considered an effective treatment. Dexedrine is contraindicated for patients with a history of substance abuse.

Certain studies have been performed regarding possible alternate use for antidepressant treatment for HIV patients with depression and debilitating fatigue, early stage physiotherapy for severe stroke victims, and treatment for those with methamphetamine (speed) addiction. Dextroamphetamine is also used to treat fatigue in cancer patients.

The drug comes in 5mg and 10mg tablets, or tabs, as well as 5mg, 10mg, and 15mg Spansules (Capsules, or caps). The most commonly used bioavailable form of dextroamphetamine is dextroamphetamine sulfate, which is a salt of d-amphetamine.

Side effects

Possible adverse effects of dexamphetamine include insomnia, reduced appetite, dependence, nervousness, restlessness, irritability, and euphoria that may be followed by fatigue and depression. There may be dryness of mouth, abdominal cramps, headache, dizziness, tremor, sweating, palpitations, increased or sometimes decreased blood pressure and altered libido. The Physician's 1991 Drug Handbook reports: "Symptoms of overdose include restlessness, tremor, hyperreflexia, tachypnea, confusion, aggressiveness, hallucinations, and panic."

There have also been reports of growth retardation of children with long-term use, although this effect can be reduced by alternating periods of abstinence from dexedrine.


As Dextroamphetamine is a stimulant, it is highly addictive and should be used with caution. The use of Dextroamphetamine for long periods of time may result in drug tolerance, and even physical dependence.

Addiction is relatively uncommon when used as prescibed, such as in cases of Attention Deficit Hyperactive Disorder and Narcolepsy. However, the drug is also widely used without a prescription, and can be abused for its sleep-inhibiting properties.
Dextroamphetamine is a Schedule II controlled substance, and possession without prescription is illegal. This is due to the extremely high potential for abuse, as well as the severe physical and psychological effects that can result from this.

Other uses

The US Air Force uses dextroamphetamine as its "go-pill." It is given to pilots on long missions to help them remain focused and alert. However, Dexedrine is being phased out in favor of Provigil as the Air Force's new go-pill.

Read more at Wikipedia.org


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Clinical quiz - continuing medical education
From American Family Physician, 5/1/03

Clinical Quiz questions are based on selected articles in this issue. Answers appear in this issue.

American Family Physician has been approved by the American Academy of Family Physicians as having educational content acceptable for Prescribed credit hours. Term of approval covers issues published within one year from the beginning distribution date of January 2003. This issue has been reviewed and is acceptable for up to 3.5 Prescribed credit hours. Credit may be claimed for one year from the date of this issue. When reporting CME credit hours, AAFP members should report total Prescribed credit hours earned for this activity. It is not necessary for members to label credit hours as evidence-based or Prescribed for CME reporting purposes.

The American Academy of Family Physicians is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The AAFP designates this educational activity for a maximum of 3.5 hours in Category 1 credit toward the American Medical Association Physician's Recognition Award. Each physician should claim only those hours of credit that he or she actually spent in the educational activity.

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Each copy of AFP contains a Clinical Quiz answer card. AAFP members may use this card to obtain the designated number of Prescribed credit hours for the year in which the card is postmarked.

AMA/PRA Category 1 Credit

AAFP members who satisfy the Academy's continuing medical education requirements are automatically eligible for the AMA/PRA.

Physicians who are not members of the AAFP are eligible to receive the designated number of credit hours in Category 1 of the AMA/PRA on completion and return of the Clinical Quiz answer card. AFP keeps a record of AMA/PRA Category 1 credit hours for nonmember physicians. This record will be provided on request; however, nonmembers are responsible for reporting their own Category 1 CME credits when applying for the AMA/PRA or other certificates or credentials. For health care professionals who are not physicians and are AFP subscribers, a record of CME credit is kept by AAFP and will be provided to you on written request. You are responsible for reporting CME hours to your professional organization.

NOTE: The full text of AFP is available online (www.aafp.org/afp), including each issue's Clinical Quiz. The table of contents for each online issue will link you to the Clinical Quiz. Just follow the online directions to take the quiz and, if you're an AAFP member, you can submit your answers for CME credit.

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Before beginning the test, please note: Each Clinical Quiz includes two types of questions: Type A and Type X.

Type A questions have only one correct answer and may have four or five choices. Here is a typical Type A question:

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