Chapter 4 Pharm: Sedative-Hypnotics & ADHD Agents Flashcards
Sedative-Hypnotics: Background Assessment data= indications
— Indications: short term management of various anxiety states and treatment of insomnia
— Selected agents are used as anticonvulsants, as pre operative sedatives, and to reduce anxiety associated with alcohol withdrawal
Sedative-Hypnotics: Background Assessment data : Action
Depression of the CNS
Exceptions: Ramelton’s sleep-promoting properties are the result of agonist activity on selective melatonin receptors
Sedative-Hypnotics: Contraindicated
Allergic, pregnant, lactation, severe hepatic, cardiac, respiratory, or renal disease
Sedative-Hypnotics: S/E
Drowsiness & confusion
Lethargy
Tolerance
Dependence
Hypotension
Abnormal thinking and behavioral changes
ADHD Agents: Action of stimulants
The CNS stimulants (Amphetamines, methylphenidate) increase levels of norepinephrine, dopamine, and serotonin in the CNS
Their effectiveness in the treatment of ADHD is thought to be based on the activation of dopamine D4 receptors, which depress motor activity
ADHD Agents: Action of Non-stimulants
Atomoxetine (straterra) inhibits the reuptake of norepinephrine and bupropion (wellbutrin) blocks the neuronal uptake of serotonin, norepinephrine and dopamine.
Clonidine and Guanacine stimulate central alpha-adrenergic receptors in the brain resulting in reduced sympathetic outflow from the CNS.
The exact mechanism by which these non-stimulant drugs produce the therapeutic effect in ADHD is unclear.
Sedative-Hypnotics: Caution
Those who are suicidal or who are addicted to drugs
ADHD Agents: Contraindications of Stimulants
Allergic to sympathomimetic amines
Clients with advanced ateriosclerosis
Cardio disease, hypertension, hyperthyroidism, glaucoma
Agitated or hyperexcitablity states, history of dug abuse
MAOIs within 14 days of use, and under 3yrs old
ADHD Agents: Contraindications of Atomoxetine and Bupropion
Contraindicated in clients with hypersensitivity to the drugs, in lactation, and in concomitant use with or within 2 weeks of using MAOIs
ADHD Agents: Contraindications of Bupropion
Seizure disorders, acute MI, bulimia or anorexia nervosa.
ADHD Agents: Contraindications of Alpha Agonists
Allergies to it
ADHD Agents: precautions for stimulants
Children, tourette’s, anorexia, insomnia
History of suicide, homicidal tendencies
Elderly
Prolonged use may result in tolerance
ADHD Agents: Precautions for Atomoxetine and bupropion
Urinary retention, hepatic, renal, cardio disease, suicidal clients, pregnant, elderly
ADHD Agents: Precautions for Alpha agonists
Coronary insufficiency, recent MI, cerebrovascular disease, renal/hepatic failure
ADHD Agents: Many S/E…. Some to know
Overstimulation, insomnia
Palpitations, tachycardia
Anorexia, weight loss
N/V
Sedation or rebound syndrome (alpha agonists)
