CNS Stimulants

Question 1

Methylphenidate

Answer 1

• Amphetamine-like drug; Schedule II
• PO, transdermal patch
• MOA: increase dopamine & norepinephrine; increase attention span & cognitive performance
• Indication: ADHD, narcolepsy
• Nursing: give early in the day, report irregular heart beat, palpitation or HTN, avoid alcohol, caffeine & nicotine, use sugarless gum to relieve dry mouth, do not stop abruptly (need to taper off to avoid withdrawal)
• Avoid while breastfeeding
• May cause tics

Question 2

Modafinil & Armodafinil

Answer 2

• Amphetamine-like drug; schedule IV
• Indication: narcolepsy, jet lag, ADHD, sleep apnea
• Nursing: give early in the day, report irregular heart beat, palpitation or HTN, avoid alcohol, caffeine & nicotine, use sugarless gum to relieve dry mouth, do not stop abruptly (need to taper off to avoid withdrawal)
• Avoid while breastfeeding
• May cause tics

Question 3

Theophylline

Answer 3

• Analeptic
• MOA: stimulates brain stem
• Indication:
  
  • IV: neonatal apnea (stimulates respiration in newborns)
  • IV: emergency respiratory depression caused by CNS depressant OD
  • IV: anesthetic recovery
  • IV/PO: bronchodilator (for asthma, COPD, status asthmatics)
• Side Effects: CNS stimulation - restlessness, tremors, twitching, insomnia, seizure, dieresis, tinnitus, tachycardia, palpitations, dysrhythmia, dependence & withdraws symptoms