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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)

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)
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
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) ```
CNS Stimulants: Methylphenidate, Amphetamine, Illicit drug= cocaine Non-Amphetamine CNS Stimulants: Modafinil
26
Treat: Shift Work Sleep Disorders, Narcolepsy, , Fatigue ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
Non-Amphetamine CNS Stimulants: Modafinil
27
Treat Shift Work Sleep Disorders ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
Non-Amphetamine CNS Stimulants: Modafinil
28
Treat: ADHD ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
Miscellaneous ADHD Agent:atomoxetine
29
MECHANISM OF ACTION Inhibits reuptake of Norepinephrine ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
Miscellaneous ADHD Agent:atomoxetine
30
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) ```
Miscellaneous ADHD Agent:atomoxetine
31
Hepatotoxicity- LFTs ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
Miscellaneous ADHD Agent:atomoxetine
32
BOXED WARNING Boxed Warning about Suicidal Ideation ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
Miscellaneous ADHD Agent:atomoxetine
33
Treat: Hypertension ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
a-2 specific agonists: Guanfacine
34
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-2 specific agonists: Guanfacine
35
ADVERSE EFFECTS Anticholinergic: xerostomia (dry mouth) Drowsiness Decreased HR/BP ``` Amphetamine Modafinil Methylphenidate Atomoxetine Illicit drug= cocaine Guanfacine (alpha 2 agonist) ```
a-2 specific agonists: Guanfacine
36
``` 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-2 specific agonists: Guanfacine

Phamacology (13 decks)

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