Central Nervous System Stimulants

Characteristics of Attention-Deficit Disorders

• Inability to concentrate on one activity for longer than a few minutes

• State of hyperkinesis

• Usually diagnosed in school-aged children, but can occur in adults

Narcolepsy Characteristics

Daytime sleepiness and sudden periods of loss of wakefulness

Narcolepsy Causes

• Problems with stimulation of the brain by the reticular activating system (RAS)

• Problems with response to that stimulation

Central Nervous System Stimulants

act at cortical and RAS, possible by increasing the release of catecholamines from presynaptic neurons leading to an increase in stimulation of the postsynaptic neurons

Central Nervous System Stimulants Indications

Central Nervous System Stimulants Pharmacokinetics

• Rapidly absorbed from the GI tract

• Peak 2-4 hours

• Metabolized in the liver

• Excreted in the urine

• T ½ 2-15 hours

Central Nervous System Stimulants Contraindications

Known allergy, marked anxiety, agitation, or tension and severe fatigue or glaucoma

Central Nervous System Stimulants Adverse Effects

Nervousness, insomnia, dizziness, headache, blurred vision, anorexia, nausea, weight loss

Central Nervous System Stimulants Drug-to-Drug Interactions

• MAO Inhibitors

• Guanethidine

• Tricyclic antidepressants

• Phenytoin

Adderall –Assessment and Teaching Points

• ADHD – indication

• Dilation of pupils

• Does not sleep – indication; Do other management CBT

• Hyperactivity-undesirable effect, Holiday from med

– High potential for developing substance abuse

• Evaluate for palpitations, tachycardia, blood pressure

• Remind client never to alter does without consultation

• Avoid MAO Inhibitors, caffeine and stimulants. Avoid OTC cold medications (sympathomimetics can increase CNS stimulant effects).

• Loss of Weight and other undesirable effects like growth suppression

• Limit – specific prescribing – Schedule 2 drug

Central Nervous System Stimulant: methylphenidate (Ritalin) Indication

narcolepsy and attention deficit disorder

Central Nervous System Stimulant: methylphenidate (Ritalin) Adverse Effects

Nervousness, insomnia, increased or decreased pulse rate, increased blood pressure, tachycardia, loss of appetite, nausea, and abdominal pain