Chapter 17 : Stimulants Flashcards
What do we use stimulants for?
ADHD
Narcolepsy
Reversal of respiratory distress
Normally why or who do we usually use reversal of respiratory distress CNS stimulants?
For pre terms babies because they forget to breathe
What of medication of stimulant do we usually for our pre term babies?
Analeptics, caffeine
What are the 3 categories we are going to talk about for CNS stimulant?
Amphetamines
Analeptics, caffeine
Anorexiants
What does amphetamines act on?
In the cerebral cortex
What does Analeptics, caffeine act on?
Brain stem and medulla
What does anorexiants act on?
On satiety center in hypothalamic and limbic areas
What is narcolepsy?
Recurrent attacks or drowsiness and sleep during normal waking activities
Like driving and talking
When you’re not suppose to be falling asleep or trying to fall asleep
Amphetamines topic!!
What is the action of amphetamines?? (2)
Stimulate release of norepinephrine and dopamines
Block reuptake of norepinephrine and dopamines
What are the 4 amphetamines CNS effects?
Mood elevation / euphoria
Increase mental alertness and capacity for work
Decreased fatigue and drowsiness
Prolonged wakefulness
What are the 3 respiratory effects of amphetamines ?
Relaxation of bronchial smooth muscle
Increase respiration
Dilation of pulmonary arteries
If you stop your ADHD medications what happens?
You feel exhausted for a while
Normally we recommended patients to slowly tapper off ADHD why?
To not feel so exhausted
Is amphetamines a long acting pill?
So we recommend they take it during?
Yes
The morning so it’s out of your system when it’s time for sleep
What are the adverse effects of amphetamines? (8)
Palpitations
Tachycardia
Hypertension
Nervousness
Restlessness
Insomnia
Anoriexa( not being hunger )
Growth suppression
Think of the fact that amphetamines is a stimulant so you’re over stimulant, so think of?
Like cardiac
You are feeling too much
Jumpy
Uncomfortable
Can’t sit still
Excess use of amphetamines what happens?
Psychosis
( This medication is psychosis based so when you’re off of it, you shouldn’t be at this risk anymore )
Amphetamines causes what type of weight ?
Weight loss appetite suppression
Decrease appetite = weight loss
Because they have upset stomach
Usually a lot of kids
End up getting
Growth suppression
Some doctors will do a baseline of what before starting amphetamines ( ADHD meds )?
Heart
To see what they are before
Amphetamines, you always want to get these people a good diet like what? Because they aren’t hungry ^
Protein
Yogurt
Fruits and vegs
What are the 2 drugs for amphetamines - like drugs for ADHD?
Methylphenidate
Dexmethylphenidate
What the function of the 2 ADHD medications?
Increase attention span and cognitive performance
Memory and reading
Decrease impulsiveness, hyperactivity and restless
What are the 3 big concerns for amphetamine drugs?
Sleep
Growth suppression
Cardiac
What does narcolepsy drugs do?
Increase wakefulness in patients with sleep disorders
Narcolepsy drugs do
Increase effects of ? (4)
Decrease effects of?
Anticoagulants, anticonvulsants, TCAS, MAOIS
Antihypertensives
Nursing implications of ADHD
Last daily dose should be given what?
Take on an ____stomach at what time?
Eat a healthy ___
Monitor child for
Physical growth, including height and weight
4-6 hours before bedtime
Empty- 30-45mins before meals
Breakfest
Notes
Amphetamine
Usually contraindicated in heart disease, hypertension, hyperthyroidism, Parkinsonism, glaucoma
Assses vital signs, monitor for increase in BP
Assess mental status, such as mood, affect and aggressiveness
Don’t discontinue suddenly
Assess complete blood count
Differential white blood cells
Platelets before and during therapy
Sugarless gum for dry mouth
If you think of hyperthyroid, has the same side effects of amphetamines, so we what?
Don’t give that medication to treat hyperthyroid
Anorexiants
What does Anorexiants do?
Appetite suppression
- cause stimulant effect on hypothalamic and limbic areas of brain
At what age should we not give Anorexiants?
Under 12 year old
What are your side effects if Anorexiants?
Restlessness
Euphoria
Insomnia
Tachycardia
Palpitations
Hypertension
Seizures
Erectile dysfunction
Analeptics
What is analeptics, caffeine used for?
Used for neonatal apnea
Used for mental alertness
What are your 6 analeptics side effects?
Palpitations
Tachycardia
Dysrthymias
Insomnia
Tremors
Restlessness
Practice question 1
What would indicate to the nurse that the child taking methylphenidate requires more teaching?
A. The child is seen drinking a cold product
B. The child checks his weight twice a week
C. The child takes the drug 45mins before a meal
D. The child takes the drug before breakfast and lunch
A.The child is seen drinking a cold product
Practice question 2
A child has been diagnosed with ADHD. Which drug dose the nurse anticipate the health care provider will prescribed?
A. Zolmitriptan
B. Doxapram
C. Benzphetamine
D. Methylphenidate
D. Methylphenidate
Practice question 3
Methylphenidate should not be taken by patients with a history of which condition?
A. Renal failure
B. Glaucoma
C. Hypothyroidism
D. Heart disease
D. Heart disease
