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Phamacology > CNS Stimulants.pptx > Flashcards

CNS Stimulants.pptx Flashcards

1
Q

CNS Stimulants For children

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Methylphenidate, amphetamine, Illicit drug= cocaine

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2
Q

Non amphetamine Stimulants for children

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Modafinil

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3
Q

Miscellaneous ADHD Agents for children

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Atomoxetine

Guanfacine (alpha 2 agonist)

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4
Q

Treat:
ADHD, Narcolepsy

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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5
Q

MECHANISM OF ACTION
These agents typically result in increased levels of norepinephrine and dopamine in the central nervous system (CNS)- may also increase serotonin levels

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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6
Q

THERAPEUTIC OUTCOME
Improved ability to stay awake (narcolepsy, sedation from opioids)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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7
Q

THERAPEUTIC OUTCOME
Improvement of ADHD symptoms (ability to focus)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine

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8
Q

ADVERSE EFFECTS
CNS Stimulation- restlessness, insomnia (avoid evening administration, take off patches after ~9 hours) causes - Anxiety, irritability, depression

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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9
Q

ADVERSE EFFECTS
CNS Stimulation- restlessness, insomnia (avoid evening administration, take off patches after ~9 hours) causes - Anxiety, irritability, depression

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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10
Q

Norepinephrine◦Increased Blood pressure, and Heart Rate (tachycardia/palpitations)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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11
Q

Increased risk for chest pain, MI, sudden death if heart abnormalities
Report SOB, chest pain, dizziness

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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12
Q

Cocaine users will receive Beta Blockers in E.D. with chest pain

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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13
Q

Decreased appetite/weight loss, growth suppression, etc.

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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14
Q

Dopamine/ Toxicity
Palpitations, Dysrhythmias, Hypertension, Hallucinations, Paranoia, Seizures

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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15
Q

Nursing Considerations
Encourage regular meal times
Assess growth/height/weight in children

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

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16
Q

Some providers will have patients take “DRUG HOLIDAYS”, stop taking on weekends/holidays/vacations, to allow appropriate growth

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

17
Q

Monitor- BP, HR, height/weight, growth,

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

18
Q

Drug to drug
Avoid other drugs (OTCs, stimulants like pseudoephedrine, limit caffeine, no alcohol, no MAO-Is, etc)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

19
Q

Administration
Take first thing in the AM (some recommend 30 minutes before food)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

20
Q

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

Administration
Take first thing in the ? (some recommend ? minutes before food)

A

AM

30

21
Q

if taking multiple times per day, avoid evening hours (4 pm cut off per ATI)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

22
Q

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

if taking multiple times per day, avoid evening hours (? pm cut off per ATI)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

4

23
Q

Patches should be applied in AM, removed in PM ( 9 hour ON time)

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

24
Q

Don’t crush XR/XL/ER pills

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

25
Q

SCHEDULE II SUBSTANCES!- Hand written prescriptions, no refills- high risk for Misuse & Euphoria RISK — tolerance/dependence potential—- Withdrawal symptoms

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine
Non-Amphetamine CNS Stimulants: Modafinil

26
Q

Treat:
Shift Work Sleep Disorders, Narcolepsy, , Fatigue

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Non-Amphetamine CNS Stimulants: Modafinil

27
Q

Treat
Shift Work Sleep Disorders

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Non-Amphetamine CNS Stimulants: Modafinil

28
Q

Treat:
ADHD

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Miscellaneous ADHD Agent:atomoxetine

29
Q

MECHANISM OF ACTION
Inhibits reuptake of Norepinephrine

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Miscellaneous ADHD Agent:atomoxetine

30
Q

ADVERSE EFFECTS/ Nursing Considerations
Similar to amphetamines/ Non- Amphetamines
Watching Blood Pressure and Heart RateWatching growth- height/weight/appetite- especially in children

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Miscellaneous ADHD Agent:atomoxetine

31
Q

Hepatotoxicity- LFTs

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Miscellaneous ADHD Agent:atomoxetine

32
Q

BOXED WARNING
Boxed Warning about Suicidal Ideation

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

Miscellaneous ADHD Agent:atomoxetine

33
Q

Treat:
Hypertension

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

a-2 specific agonists: Guanfacine

34
Q

MECHANISM OF ACTION
stimulate α2 receptors on presynaptic nerve terminals in brain stem (vasomotor center), which reduces sympathetic outflow from CNS
ADVERSE EFFECTS

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

a-2 specific agonists: Guanfacine

35
Q

ADVERSE EFFECTS
Anticholinergic: xerostomia (dry mouth)
Drowsiness
Decreased HR/BP

Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

a-2 specific agonists: Guanfacine

36
Q 
Nursing Considerations
Monitor vital signs
Taper off
Anticholinergic effects
CNS sedation- counsel patients (driving, alcohol, weight gain)
Amphetamine
Modafinil
Methylphenidate
Atomoxetine
Illicit drug= cocaine
Guanfacine (alpha 2 agonist)
A

a-2 specific agonists: Guanfacine

Phamacology (13 decks)

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