CNS Stimulants

Question 1

Drug class: Central Nervous System Stimulants
Drug names/ suffixes in this class?

Answer 1

-dafinil
-amphetamine

●Amphetamine
●Armodafinil
●Atomoxetine
●Dexmethylphenidate
●Dextroamphetamine
●Lisdexamfetamine
●Methylphenidate
●Modafinil

Question 2

Drug class: Central Nervous System Stimulants
What are the actions?

Answer 2

○CNS stimulants possibly act by increasing the release of catecholamines from
presynaptic neurons leading to an increase in stimulation of the postsynaptic neurons
○Amphetamine stimulants block reuptake of norepinephrine and dopamine and
increase more of their release

Question 3

Drug class: Central Nervous System Stimulants
What are the indications?

Answer 3

○ADHD
○Narcolepsy and various sleep disorders

Question 4

Drug class: Central Nervous System Stimulants
What are the contraindications?

Answer 4

○Known allergy, marked anxiety, agitation, or tension and severe fatigue or glaucoma,
cardiac disease

Question 5

Drug class: Central Nervous System Stimulants
What are the cautions?

Answer 5

○History of seizures; history of drug dependence, including alcoholism; hypertension
○Pregnancy and lactation

Question 6

Drug class: Central Nervous System Stimulants
What are the adverse effects?

Answer 6

○Nervousness, insomnia, dizziness, headache, blurred vision, anorexia, nausea, weight loss

Question 7

Drug class: Central Nervous System Stimulants
What are the drug-drug interactions?

Answer 7

○MAOI/TCAs
○Some OTC cold medications
○Caffeine

Question 8

Nursing Considerations for Central Nervous System Stimulants
Assessments:

Answer 8

○Assess for contraindications or cautions
○Perform physical assessment
-Assess temperature; body weight, skin color, and lesions
-Assess orientation, affect, and reflexes; ophthalmic examination
-Monitor bowel sounds and reported output; urinary output
-Assess pulse, auscultation, and blood pressure, including orthostatic
blood pressure; respiration rate and adventitious sounds
○Obtain a CBC

Question 9

Nursing Considerations for Central Nervous System Stimulants
Nursing diagnoses:

Answer 9

○Altered thought processes related to CNS effects of the drug
○Altered vital signs related to CV effects of the drug
○Injury risk related to CNS and visual effects of the drug
○Knowledge deficiency regarding drug therapy

Question 10

Nursing Considerations for Central Nervous System Stimulants
Implementations:

Answer 10

○Ensure proper diagnosis of behavioral syndromes and narcolepsy
○Arrange for an overall treatment plan that includes family and cognitive–behavior therapy
○Arrange to interrupt the drug periodically in children who are receiving the drug for behavioral syndromes
○Arrange to dispense the least amount of drug possible
○Administer drug before 6 pm
○Monitor weight, CBC, and ECG
○Consult with the school nurse or counselor
○Provide safety measures if CNS effects occur
○Provide thorough patient teaching

Question 11

Nursing Considerations for Central Nervous System Stimulants
Evaluation:

Answer 11

○Monitor patient response to the drug (decrease in manifestations of behavioral syndromes, decrease in daytime sleep and narcolepsy).
○Monitor for adverse effects (CNS stimulation, CV effects, rash, physical or psychological dependence, GI dysfunction).
○Evaluate effectiveness of the teaching plan (patient/family can give the drug name and dosage, name possible adverse effects to watch for and specific
measures to help avoid adverse effects and describe the need for follow-up and evaluation).
○Monitor effectiveness of comfort measures and adherence to the regimen.