Chapter 13 CNS Stimulants and Related Drugs

Question 1

CNS stimulants are the 1st line of drugs for ________ and ______

Answer 1

narcolepsy, ADHD

Question 2

amphetamines

Answer 2

elevate mood, increase energy and alertness, decrease appetite, enhance task performance

Question 3

amphetamine mechanism of action

Answer 3

-stimulate areas of the brain associated with mental alertness
- mood elevation, euphoria, increased alertness and capacity for work, decreased fatigue, prolonged wakefulness
-increased effects of dopamine and norepi in CNS synapses by increasing their release and blocking their reuptake. Dopamine and norepi stay in contact with their receptors longer which lengthens the duration of action

Question 4

amphetamine indications

Answer 4

periodic drug holidays recommended to diminish addiction

Question 5

amphetamine counter indications

Answer 5

known allergy, cardiac structural abnormalities, can increase anxiety, tourette’s syndrome, HTN, glaucoma

Question 6

amphetamine adverse effects

Answer 6

“speed up” body systems

Question 7

ADHD and Narcolepsy drug examples

Answer 7

-Amphetamines (aderol)
-Atomoxetine
-Methylphenidate
-Modafinil - takes 2 months to take effect

Question 8

anorexiants

Answer 8

CNS stimulant to promote weight loss in obesity
- effectiveness has not been proven

Question 9

anorexiants mechanism of action

Answer 9

suppress appetite control centers in the brain, increases body’s basal metabolic rate

Question 10

anorexiants indications

Answer 10

treatment of obesity requires lifestyle changes - BMI over 30

Question 11

anorexiants counter indications

Answer 11

known allergy, severe CAD, HTN, hyperthyroidism, mental agitation, history of drug abuse, eating disorders

Question 12

anorexiants adverse effects

Answer 12

increased BP, cause palpitations, dysrhythmias, anxiety, dizziness, headache

Question 13

anorexiant drug examples

Answer 13

-Phentermine - CNS stimulant
-Orlistat - non CNS stimulant, OTC, supplement with vitamins

Question 14

antimigraine

Answer 14

-serotonin receptor agonists
-Botox- BB Warning - spread of toxin beyond site of injection- can cause breathing difficulties

Question 15

antimigraine mechanism of action

Answer 15

-triptans stimulate serotonin receptors in cerebral arteries causing vasoconstriction
-triptans reduce production of inflammatory neuropeptides, constrict vessels in brain

Question 16

triptans

Answer 16

indicated for abortive therapy of migraines, not preventative

Question 17

antimigraine rescue therapy drugs

Answer 17

-Fioricet- tylenol/ aspirin, butalbital, caffeine, codeine
-Caffeine- help with absorption of ergots, vasoconstrict, diuretic to decrease cerebral blood flow

Question 18

antimigraine counter indicatons

Answer 18

allergy, CV disease, HTN, dysrhythmias, glaucoma, CAD

Question 19

antimigraine adverse effects

Answer 19

vasoconstrictor effects, overuse can = rebound headaches

Question 20

antimigraine drug examples

Answer 20

-Serotonin Receptor Agonist (triptans)- relief in 2 hours - can be given PO, SL, Subcut, nasal spray
-Ergot Alkaloids- not used as frequently as triptans- can be given PO, injectable, nasal spray, with caffeine

Question 21

analeptics

Answer 21

used to treat neonatal and respiratory depression
-increase reflex excitability especially in respiratory tract

Question 22

analeptics mechanism of action

Answer 22

-stimulates areas of CNS controlling respiration- medulla and spinal cord
-smooth muscle relaxation of respiratory tract, dilation of pulmonary arterioles and stimulation of CNS

Question 23

analeptics indications

Answer 23

neonatal apnea, bronchopulmonary dysplasia, hypercapnia with COPD, postanesthetic respiratory depression

Question 24

analeptics counter indications

Answer 24

known allergy, peptic ulcer disease , CV conditions

Question 25

analeptics adverse effects

Answer 25

increased doses can stimulate vagal, vasomotor and respiratory centers of the medulla in the brainstem, increased blood flow to skeletal muscles

Question 26

analeptic drug examples

Answer 26

-Caffeine - CNS stimulant found in OTC drugs in combination with prescription drugs in food and beverages
-Doxapram- use with supportive measures with respiratory depression involving anesthetcs or drugs of abuse, COPD hypercapnia
-DONT use on infants

Question 27

types of IV caffeine:

Answer 27

-caffeine citrate- used for neonatal
-caffeine sodium benzoate- used for adults