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Chapter 20 - CNS Stimulants
CNS stimulants
89
Pharmacology
Undergraduate 3
04/10/2014

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Term
Medically approved use of CNS stimulants are limited to the use of:
Definition
ADHD
Narcolepsy
Obesity
Reversal of respiratory distress
Term
Amphetamines and caffeine are the major group of CNS stimulants, which stimulate:
Definition
The cerebral cortex of the brain.
Term
_______ & ________ act on the brainstem and medulla to stimulate respiration.
Definition
Analeptics & caffeine
Term
Anorexiants act to some degree on the ____ _____ and _______ to supress _____.
Definition
Cerebral cortex
Hypothalamus
Appetite
Term
Long term use of amphetamines can produce __________ ___________ & _______.
Definition
Psychological dependence
Tolerance
Term
What might cause ADHD
Definition
Dysregulation of the transmitters serotonin, norepinephrine, and dopamine.
Term
T/F: Intelligence is usually affected in children with ADHD.
Definition
False
Term
What is characterized by falling asleep during normal waking activities.
Definition
Narcolepsy
Term
What usually accompanies narcolepsy, affecting voluntary muscles?
Definition
Sleep paralysis
Term
Amphetamines stimulate the release of neurotransmitters _____ & _____
Definition
Norepinephrine
Dopamine
Term
Amphetamines can cause, besides euphoria and alertness:
Definition
sleeplessness, restlness, tremors, and irritability.
Term
What are cardiovascular problems associated with the continuous use of amphetamines?
Definition
Increased HR, palpitations, cardiac dysrhythmias, and increased BP
Term
What is the t1/2 of amphetamines?
Definition
4-30 hrs
Term
What type of urine excretes amphetamines faster?
Definition
Acidic
Term
For what are amphetamines prescribed?
Definition
Narcolepsy, and in some cases ADHD
Term
Which are the three amphetamine drugs that may be prescribed for effective control of ADHD?
Definition
Adderall
Dexedrine
Desoxyn
Term
What are the side effects and adverse reactions of amphetamines?
Definition
Restlessness
Insomnia
Tachycardia
Hypertension
Heart palpitations
Dry mouth
Anorexia
Weight loss
Diarrhea
Constipation
Impotence
Term
What are two amphetamine-like drugs used to increase a child's attention span and cognitive performance?
Definition
Ritalin
Focalin
Term
Ritalin and Focalin are amphetamine-like drugs used to:
Definition
Increase a child's attention span and cognitive performance and to decrease impulsiveness, hyperactivity, and restlessness.
Term
Which amphetamine-like drug may be used to treat narcolepsy?
Definition
Ritalin
Term
What is a drug prescribed for narcolepsy that increases the amount of time clients feel awake? Its MOA is not fully known.
Definition
Provigil
Term
What is the most frequently prescribed drug to treat ADHD?
Definition
Ritalin
Term
How often and when is Ritalin usually administered to children?
Definition
Twice/Day
Before breakfast and lunch
30-45 minutes before meals as food affects absorption
Term
How long before bed should Ritalin be administered?
Definition
At least 6 hours before sleep
Term
What is a secondary use of Ritalin
Definition
Narcolepsy
Term
Which type of drug is considered more effective in treating ADHD than amphetamines, with the exception of Adderall?
Definition
Amphetamine-like
Term
Which type of CNS stimulant is generally avoided because of its higher potential for abuse, habituation, and tolerance?
Definition
Amphetamines
Term
Which drugs enhance the actions of Ritalin?
Definition
Sympathomimetics, such as decongestants.
Term
Foods/drinks containing what should be avoided when taking Ritalin because they increase drug action?
Definition
Caffeine
Term
Which drugs can decrease the action of amphetamines and amphetamine-like drugs?
Definition
Antihypertensives
Barbituates
Term
What was once freely prescribed as an anorexiant?
Definition
Amphetamines?
Term
Amphetamines are not currently recommended for the use of appetite suppressants because of:
Definition
Tolerance
Psychological dependence
Abuse
Term
FDA has ordered the removal of ____________ from OTC eight-loss drugs and cold remidies.
Definition
phenylpropanolamine
Term
The risk for _________ _______ in young women who take drugs containing phenylpropanolamine is increased 16x.
Definition
hemorrhagic stroke
Term
Phenylpropanolamine has not been associated with an increased risk for _____ in men.
Definition
Stroke
Term
Adverse reactions to phenylpropanolamine are
Definition
Renal failure
Psychosis
HTN
Cardiac dysrhythmias
Term
T/F: Topical use of phenylpropanaloamine causes systemic effects when used topically.
Definition
F - This has not been proved to be true
Term
For weight loss attempts, emphasis should be place on:
Definition
Nutrition
Exercise
Behavior modification
Term
T/F: Individuals taking anorexiants should be under the supervision of a nutritional counselor.
Definition
False - They should be under the care of a HCP
Term
Children younger than __ y.o.a. should not be given anorexiants.
Definition
12
Term
Self-medication with anorexiants is _____.
Definition
Discouraged
Term
Long-term use of anorexiants frequently result in severe side effects such as:
Definition
Nervousness
Restlessness
Irritability
Insomnia
Heart palpitations
HTN
Term
The primary use of an analeptic is to
Definition
Stimulate respirations
Term
A subgroup of analeptics is _______, which is made up of ________ & _______.
Definition
Xanthines
Caffeine
Theophylline
Term
Caffeine stimulates the ______, and in large doses it _________ _________.
Definition
CNS
Stimulates respiration
Term
Newborns with RD may be given ________ to increase respiration.
Definition
Caffeine
Term
_________ is used primarily to ______ ___ _________. However it has also been used to increase respirations in newborns.
Definition
Relax the bronchioles
Term
SE from caffeine are similar to those from anorexiants:
Definition
Nervousness
Restlessness
Tremors
Twitching
Palpitations
Insomnia
Term
SE of caffeine that are not similar to those of anorexiants include:
Definition
Diuresis
GI irritation
Tinnitus (rarely)
Term
More than ___ mg of caffeine affects the CNS and heart.
Definition
300
Term
T1/2 of caffeine is
Definition
5 hrs.
Term
In what type of clients is the t1/2 of caffeine increased?
Definition
Liver disease
Oral contraceptives
Pregnant
Term
T/F: Caffeine is not contraindicated during pregnancy.
Definition
False - the effects on the fetus are unknown.
Term
Dopram is a ____ & _______ _______ used to treat respiratory depression caused by overdose, pre- and postanesthetic respiratory depression, and COPD.
Definition
CNS and respiratory stimulant
Term
T/F: Dopram can be used for the treatment of neonatal apnea.
Definition
True - but it should be used with caution.
Term
What is the route of administration of Dopram?
Definition
IV.
Term
What is the onset of action of Dopram?
Definition
20-40 seconds.
Term
What is the peak action of Dopram?
Definition
2 minutes
Term
What are the SE of Dopram?
Definition
HTN
Tachycardia
Tremors
Spasticity
Hyperactive reflexes
Term
What is more effective than Dopram for treating clients experiencing respiratory distress as a result of using certain drugs?
Definition
Mechanical ventilation
Term
Ritalin is contraindicated in
Definition
Hyperthyroidism
Anxiety
Hx of seizures
CAD, HTN
Tourettes
Glaucoma
Psychosis
Mental Depression
Children younger than 6
Substance abusers
Pregnant women
Term
Ritalin is well/poorly absorbed for the GI tract?
Definition
Well absorbed from the GI tract
Term
MOA of Ritalin:
Definition
Acts primarily on the RAS and cerebral cortex.
Term
Ritalin may decrease effects of
Definition
decongestants, antihypertensives, barbituates, and may alter the effects of insulin therapy.
Term
Ritalin increases hypertensive crisis with
Definition
MAOIs
Term
Ritalin increases effects of
Definition
Oral anticoagulants
Anticonvulsants
Tricyclic antidepressants
Term
____ may increase the effects of Ritalin.
Definition
Caffeine
Term
AR of Ritalin include:
Definition
Tachycardia
HTN
Growth supression
Palpitations
Transient loss of weight in children
Term
Life-threatening AR of Ritalin
Definition
Exfoliative dermatitis
Uremia
Thrombocytopenia
Hepatoxicity
Term
The onset of Ritalin is
Definition
0.5 to 1 hr
Term
Duration of Ritalin
Definition
4-6 hours
Term
Because of the risk for thrombocytopenia when taking Ritalin, it is important to assess before and during:
Definition
CBC, WBCs, and platelets
Term
T/F: During treatment with Ritalin, a risk for delayed growth and development related to treatment is a possibility.
Definition
True
Term
Withdrawal symptoms of Ritalin include:
Definition
N/V
Weakness
Headache
Term
Dry mouth is a side effect of ____ that can be relieved by _____ ____.
Definition
Ritalin
Chewing gum
Term
When discontinuing Ritalin, what is important to teach the client?
Definition
Taper off
Term
Who should be taught to avoid all CNS stimulants?
Definition
Pregnant and nursing mothers.
These drugs are excreted in the breast milk and can cause the same side effects in the infant.
Term
Ritalin may cause anorexic effects, so parents should _____________________.
Definition
Provide children a nutritional breakfast.
Term
It is important to teach the client to report _______ & ________ when on Ritalin therapy.
Definition
Tachycardia
Palpitations
Term
Monitor children for onset of ________ when taking Ritalin.
Definition
Tourette's
Term
When evaluating effectiveness of Ritalin therapy, it is important to monitor
Definition
Weight
Sleep patterns
Mental Status
Term
Amphetamine drugs include:
Definition
Adderall
Dexedrine
Desoxyn
Vyvanse
Term
Amphetamine-like drugs include:
Definition
Ritalin
Provigil
Focalin
Strattera
Nuvigil
Cylert
Term
Anorexiants include
Definition
Didrex
Dexedrine
Tenuate
Fastin
Adipex
Acutrim
Dexatrim
Xenical
Term
The maximum dose for Didrex, an anorexiant, is
Definition
150 mg/day
Term
Drugs without phenylpropanolamine include
Definition
Acutrim
Dexatrim
Xenical
Term
Analeptics are made up of a subcategory:
Definition
Methylxanthines
Term
Methylxanthines are in a subgroup of analeptics. This subgroup is made up of
Definition
Caffeine
Theophylline
Term
A drug used for treatment of respiratory depression. It is a respiratory stimulant called
Definition
Dopram
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