CNS stimulants

Question 1

CNS Stimulants Uses.

Answer 1

1. )Attention-deficit/hyperactivity disorder (ADHD)
2. )Narcolepsy
3. )Reversal of respiratory distress.

Question 2

CNS categories.

Answer 2

1.)Amphetamines
     .Act on cerebral cortex.
2.)Analeptics, caffeine
       .Acts on brainstem
        and medulla.
3.)Anorexiants.
       .Act on satiety center in hypothalamic and limbic areas

Question 3

Attention-Deficit/Hyperactivity Disorder

Answer 3

Pathophysiology : Dysregulation of transmitters
Serotonin, norepinephrine, dopamine

Epidemiology: Usually occurs in children before age 7 years
More common in boys

Characteristics: Inattentiveness, inability to concentrate
Restlessness, hyperactivity, impulsivity
Inability to complete tasks, poor coordination

Question 4

Narcolepsy

Answer 4

Recurrent attacks of drowsiness and sleep during normal waking activities.
Driving.
Talking.
Eating.
Standing.
Sleep paralysis.

Question 5

Amphetamines Actions.

Answer 5

Stimulate release of norepinephrine and dopamine

Inhibit reuptake of norepinephrine and dopamine

Question 6

Amphetamines Side effects.

Answer 6

Tachycardia.
Palpitations. Hypertension.
Restlessness.
Irritability.
Confusion.
Euphoria.
Insomnia.
Blurred vision.
Dysrhythmias.
Tremors
Blurred vision.
Anorexia.
Dry mouth.
Weight loss.
Diarrhea.
Constipation.
Erectile dysfunction.
Excess use: psychosis

Question 7

Amphetamine-Like Drugs for ADHD

Answer 7

Methylphenidate
Dexmethylphenidate

Uses: Increase attention span and cognitive performance
Memory, reading
Decrease impulsiveness, hyperactivity, and restlessness

Question 8

Amphetamine-Like Drugs for Narcolepsy

Answer 8

Methylphenidate
Modafinil
Action—Not fully understood

Uses:Both drugs increase wakefulness in patients with sleep disorders

Question 9

Methylphenidate (Ritalin)

Action.

Answer 9

Modulates serotonergic pathways by affecting changes in dopamine transport

Question 10

Methylphenidate (Ritalin)

Uses.

Answer 10

ADHD
Narcolepsy
Increase attention span

Question 11

Methylphenidate (Ritalin)

Interactions.

Answer 11

Caffeine may increase effects.
Increases effects of oral anticoagulants,barbiturate ,anticonvulsants, TCAs, MAOIs.
Decreased effects of antihypertensive.
May alter insulin effects.
Can’t eat cheese or drink wine.

Question 12

Methylphenidate (Ritalin)

Side Effects.

Answer 12

Tachycardia
Palpitations
Hypertension
Dysrhythmias
Restlessness
Tremors
Irritability
*Dizziness
Headache
Blurred vision
Euphoria
Confusion
Anorexia
Dry mouth
Diarrhea
Constipation
Weight loss
*Seizure
Erectile dysfunction

Question 13

Nursing Process: Methylphenidate

Answer 13

Assessment:
Assess vital signs to be used for future comparison.

Nursing diagnoses:
Health behavior, risk-prone (impulsiveness, short attention span, distractibility) that interferes with peer relationships, learning, and discipline.

Planning:
Patient’s attention span will increase.
Patient will behave in a calm manner.

Nursing interventions:
Teach patient to take the drug before meals.
Advise patients to avoid foods that contain caffeine.
Report irregular heartbeat.
Record height, weight, and growth of children.
Avoid alcohol, caffeine.
Use sugarless gum to relieve dry mouth.
Do not stop abruptly; taper off to avoid withdrawal symptoms.
Evaluation

Question 14

Anorexiants

Answer 14

Cause stimulant effect on hypothalamic and limbic areas of brain to suppress appetite
Should not be given to children under 12

Question 15

Anorexiants Side Effects.

Answer 15

Nervousness
Irritability
Insomnia
Tachycardia
Hypertension
Palpitations
Seizures

Question 16

Analeptics.

Answer 16

1.)Caffeine, theophylline:
Used for neonatal apnea

2.)Doxapram:
Used for post anesthesia respiratory depression.

Question 17

What would indicate to the nurse that the child taking methylphenidate requires more teaching?

Answer 17

The child is seen drinking a cola product.

Question 18

A child has been diagnosed with attention-deficit/hyperactivity disorder. Which drug does the nurse anticipate the health care provider will prescribe?

Answer 18

Methylphenidate

Question 19

Methylphenidate should not be taken by patients with a history of which condition?

Answer 19

Mental depression

Glaucoma

Question 20

A patient has been ordered a transdermal patch of methylphenidate. The nurse teaches the family to leave the patch on for how long?

Answer 20

9 hours

Question 21

When providing teaching to a group of parents regarding attention-deficit/hyperactivity disorder (ADHD), which information will the nurse include?

Answer 21

Learning disabilities are often present in the child who has ADHD.