central nervous system stimulants and related drugs (4)

Question 1

what is the most common psychiatric disorder in children

Answer 1

attention deficit hyperactivity disorder (ADHD)

• boys > girls
• poor attention span, hyperactivity, impulsivity

Question 2

_____: unexpected falling asleep during normal daily activities

Answer 2

narcolepsy

(cataplexy: sudden falling acute skeletal muscle weakness)

Question 3

______: common type of recurring headache, usually lasting 4-72 hours

Answer 3

migraine

Question 4

________: increase specific CNS nerve/receptor excitability to control behaviors

Answer 4

CNS stimulants

(sympathomimetic drugs cause mimicking response of the flight-fight response)

Question 5

name two nonamphetamines (ADHD)

Answer 5

• atomoxetine (must be at least 6yrs old)
• modafinil (approved for narcolepsy for narcolepsy with night-shift workers; lower abuse potential)

Question 6

_______: stimulate areas of the brain associated with mental alertness and lowers appetite

Answer 6

amphetamines (ADHD/narcolepsy/obesity)

(improved oxygenation, improved mood and work.learning capacity, decreased fatigue/drowsiness)

Question 7

name three examples of amphetamines

Answer 7

methylphenidate, dextroamphetamine, amphetamine

Question 8

name some adverse effects of amphetamines

Answer 8

angina and dysrhythmias

(“speed up” body systems)

Question 9

what is an adverse effect of amphetamines in children

Answer 9

slows growth and development in children (must monitor height/weight)

Question 10

when should the last daily dose of amphetamines be given

Answer 10

• should be given 4-6 hours before bedtime to reduce insomnia (EMPTY STOMACH)

Question 11

for amphetamines what are drug “holidays”

Answer 11

allow breaks from side effects, treatment evaluation, allow growth/development

(instruct parents to keep a journal to monitor child’s response to therapy; monitor child for continued physical growth - height/weight)

Question 12

anorexiants are _____

Answer 12

stimulants

Question 13

name two stimulant (anorexiant) drug examples

Answer 13

benzphetamine, methamphetamine

Question 14

what time of day should anorexiants (stimulates) be taken

Answer 14

in the morning

Question 15

what should be limited and carefully supervised when taking anorexiants (stimulants)

Answer 15

• careful, supervised diet and exercise
• limit caffeine/stimulants; no alcohol

(manage anticholinergic effects)

Question 16

_____ is an anorexiant nonstimulant

Answer 16

orlistat

Question 17

what two things do anorexiant nonstimulants inhibit

Answer 17

• intestinal absorption caloric intake from fatty foods
• inhibits enzyme lipase

Question 18

name some side effects of orlistat (anorexiant nonstimulants)

Answer 18

oily spotting, flatulence, fecal incontinence oily stools

(restrict dietary of fat to less than 30
5 of total calories helps reduce GI side effects)

Question 19

______: absorptive therapy for migraines (given with acute migraine - not for daily maintenance)

Answer 19

antimigraine drugs

Question 20

name three examples of antimigraine drugs

Answer 20

• serotonin agonists
• onabotulinumtoxin A (for chronic migraines)
• ergot alkaloids

Question 21

name an example of a serotonin agonist

Answer 21

sumatriptan

Question 22

what is an adverse effect of serotonin agonists

Answer 22

vasoconstriction (high BP)
- BP must be below 150 systolic to administer

Question 23

what is the black box warning for onabotulinumtoxin A

Answer 23

toxin may spread past injection site resulting in dysphagia and breathing difficulties

Question 24

what is the black box warning for ergot alkaloids

Answer 24

toxin may spread past injection site causing dysphagia and breathing difficulties

Question 25

name some adverse effects of ergot alkaloids

Answer 25

chest pain, confusion, slurred speech, vision changes need immediate medical attention

Question 26

name some side/adverse effects for analeptics (respiratory depression syndrome)

Answer 26

elevated respiratory rate (usually desired effect) - must watch for issues with airway, breathing, and circulation

Question 27

name some nursing implications of analeptics (overdose/chronic use)

Answer 27

- overdose or chronic use cause insomnia, anxiety, and restlessness

Question 28

what is a nursing implication for children taking analeptics

Answer 28

assess baseline height and weight

Question 29

_____ is an example of an analeptic

Answer 29

caffeine

Question 30

use caffeine with caution in patients with a history of what

Answer 30

peptic ulcer, recent myocardial infarction (heart attack), dysrhythmias

Question 31

nursing implications for ADHD medications

Answer 31

decreases hyperactivity, increased attention span and concentration (Monitor for therapeutic responses)

Question 32

nursing implications for anorexiants

Answer 32

appetite control and weight loss (Monitor for therapeutic responses)

Question 33

nursing implications for serotonin agonists

Answer 33

decrease in frequency, duration, and severity of migraines (Monitor for therapeutic responses)