CNS stimulants

Question 1

How are CNS stimulants classified

Answer 1

• Chemical structure (Amphetamines, serotonin agonists, sympathomimetics, Xanthines)
• Site of therapeutic action
• Therapeutic use (ADHD, Antinarcoleptic, anorexiant, antimigraine, analeptic)

Question 2

What is ADHD

Answer 2

Inappropriate ability to maintain attention span (hyperactivity or Hypoactivity)

Question 3

T or F Drug therapy is different for both childhood and adult For ADHD

Answer 3

false It is the same treatment

Question 4

What is narcolepsy

Answer 4

Incurable condition where patients unexpectedly fall asleep in the middle of normal activates. May or may not happen with cataplexy

Question 5

What is Cataplexy

Answer 5

Sudden acute skeletal muscle triggered by strong emotion where commonly knees buckle and individuals fall on the floor (patient may still be awake)

Question 6

What are migraines

Answer 6

Recurring headaches with pulsatile pain that worsens with each pain. Often unilateral but may be bilateral
From decreased serotonin

Question 7

How long do migraines last

Answer 7

4-72hrs

Question 8

Symptoms of migraines

Answer 8

Nausea and vomiting, Photophobia (light) Phonophobia(sound)

Question 9

Categories of drugs to treat ADHD and Narcolepsy

Answer 9

Amphetamines, nonamphetamines, Nonstimulant drugs

Question 10

Ex of amphetamines

Answer 10

Methylphenidate (ritalin), Amphetamine aspartate (adderall)

Question 11

Ex. Nonamphetamine stimulant

Answer 11

Modafinil (for treatment of narcolepsy)

Question 12

Ex. of Nonstimulant drugs

Answer 12

Atomoxetine (also treats ADHD)

Question 13

Amphetamines MOA

Answer 13

Stimulates area of brain associated with mental alertness

Question 14

CNS/Respiratory Drug effects of amphetamines

Answer 14

CNS
- Mood elevation or euphoria
- Increase mental alertness and capacity for work
- Decreased fatigue and drowsiness
- Prolonged wakefulness
Respiratory
- Relaxation of bronchial smooth muscle
- Increased respiration
- Dilation of pulmonary arteries

Question 15

Common adverse effects of amphetamines

Answer 15

The speeding up of body systems. These include…
- Palpitations, Tachycardia, Hypertension, angina, anxiety, insomnia, headache, tremor, nausea, vomiting, diarrhea, dry mouth, increase metabolic rate

Question 16

Atomoxetine Hydrochloride

Answer 16

Treats ADHD for those older than 6 but may cause suicidal thinking

Question 17

Methylphenidate Hydrochloride

Answer 17

First prescription drug given for ADHD and narcolepsy

Question 18

Modafinil

Answer 18

For narcolepsy and day time sleepiness due to shift work. Harder to misuse than amphetamines and methylphenidate

Question 19

What are Anorexiants

Answer 19

used to treat obesity but has not been proven to be effective (not given in Canada)

Question 20

A nonstimulant drug related to Anorexiants

Answer 20

Orlistat: inhibits absorption of caloric intake from fatty foods, must be on fat soluble vitamins, contraindicated in IBS

Question 21

Adverse effects of orlistat

Answer 21

Headache, Upper respiratory infection, GI distress, Fecal incontinence
- reduce intake of fat to lessen adverse effects

Question 22

Two types of Antimigraine Drugs

Answer 22

Triptans (serotonin agonists) and ergot derivates

Question 23

MOA of Triptans (serotonin agonists)

Answer 23

Stimulate 5HT receptors in the brain Causing vasoconstriction and reducing headache symptoms and inflammatory neuropeptides

Question 24

Example of a triptan(serotonin agonists)

Answer 24

Sumatriptan

Question 25

Adverse effects of Triptans (serotonin agonists)

Answer 25

• Vasoconstriction
• Irritation at the injection site
• Tingling, flushing, congestion

Question 26

What are Analeptics

Answer 26

Drugs that stimulate the CNS to Control respirations

Question 27

Example of analeptics

Answer 27

Caffeine

Question 28

Where can one find caffeine contained in

Answer 28

OTC, Food and Bev, Combination prescription drugs(fiorinal-C1/2)

Question 29

Caution in patients taking caffeine with history of

Answer 29

Peptic ulcers
Recent MI
Dysrhythmias

Question 30

MOA of caffeine

Answer 30

Antagonizes(blocks) adenosine receptors stimulating respiratory control (increase RR)

Question 31

Adverse effects of Analeptics(vagal, Vasomotor, respiratory, MSK)

Answer 31

• Vagal: Stimulation of gastric secretion, diarrhea and reflex tachycardia
• Vasomotor: flushing, sweating
• Respiratory: elevated respiratory rate
• MSK: muscular tension and tremors

Question 32

assess children’s ___ and ___ before giving stimulant

Answer 32

Height and weight. Stimulants can cause weight loss

Question 33

When should the last daily dose of an ADHD drug be given? why?

Answer 33

Be given 4-6hrs before bed time to reduce insomnia

Question 34

medication free times for ADHD drugs

Answer 34

-drug holiday
- periods where you dont take the medication to maintain/gain weight

Question 35

When should ADHD drugs be taken for meals

Answer 35

Taken on an empty stomach 30-45 min before meals

Question 36

When should one take anorexiants

Answer 36

In the morning

Question 37

What should one avoid when taking anorexiants

Answer 37

Caffeine

Question 38

What are the forms of triptans or Selective serotonin receptor agonists

Answer 38

• Dissolvable wafers
• Nasal spray
• Self injectable

Question 39

What should one monitor when on analeptics? Why?

Answer 39

Pay attention to ABCs as the patients sensorium is diminished (their ability to sense)