ADHD medications

What is the mechanism of action of CNS stimulants (amphetamines & amphetamine-like drugs)?

Increase dopamine and norepinephrine in the brain by promoting their release and/or blocking reuptake, improving attention and impulse control.

What are the therapeutic effects of CNS stimulants in ADHD?

improved focus, decreased distractability, decreased hyperactivity, and suppression of aggression (higher doses)

what are common side effects of CNS stimulants?

insomnia, anorexia, headache, increased aggression (at lower doses)

What are contraindications for CNS stimulant use?

history of substance abuse, severe anxiety, tics/Tourette’s, cardiovascular conditions

How can you educate patients to reduce the risk of insomnia from CNS stimulants?

administer medication early (before 4PM), use extended-release formulations in the morning, avoid caffeine, and promote regular sleep habits

what is the mechanism of action of atomoxetine (Strattera)?

selective norepinephrine reuptake inhibitor; increases norepinephrine availability in the brain

what are the therapeutic effects of atomoxetine in ADHD?

reduces impulsivity, anxiety, distractibility, restlessness, and hyperactivity

what are common side effects of atomoxetine?

Drowsiness, insomnia, GI upset, dizziness, urinary retention, possible increased BP/HR, rare liver injury, and suicidal ideation

What should nurses monitor in patients taking atomoxetine?

Liver function tests, vital signs, mood changes, and therapeutic effect (which may take 4–6 weeks).

What is the mechanism of action of alpha-2 adrenergic agonists (clonidine, guanfacine)?

Stimulate alpha-2 receptors → reduce sympathetic output → modulate norepinephrine signaling.

What are the therapeutic effects of clonidine and guanfacine in ADHD?

Decrease impulsivity, distractibility, anxiety, hyperactivity, agitation, and improve frustration tolerance.

What are common side effects of alpha-2 adrenergic agonists?

Sedation, fatigue, dizziness, hypotension, bradycardia, dry mouth, constipation.

What nursing considerations are important with clonidine and guanfacine?

Monitor BP and HR, assess for sedation, and avoid abrupt withdrawal due to risk of rebound hypertension.