20.8e Central Nervous System Stimulants

CNS stimulants

Stimulating the CNS is desirable in certain circumstances such as fatigue, drowsiness, narcolepsy, obesity, and attention deficit hyperactivity disorder.

two techniques

Broadly, (?) can accomplish this: Increasing the release or effectiveness of excitatory neurotransmitters or decreasing the release or effectiveness of inhibitory neurotransmitters.

three pharmacologic classes

Within the functional class of CNS stimulants are (?) : amphetamines, methylphenidates, and methylxanthines.

methamphetamine

The amphetamines also include (?) and dextroamphetamine.

excitatory neurotransmitters

All of these medications increase the release of (?) including norepinephrine and dopamine.

Norepinephrine

(?) is the primary cause of these medications’ effects, which include an increased wakefulness and awareness as well as a decreased appetite (Figure 20-13).

drowsiness and fatigue

Amphetamines’ most common uses, therefore, are treating (?) and suppressing the appetite.

overstimulation

Most side effects of amphetamines result from (?); they include tachycardia and other arrhythmias, hypertension, convulsions, insomnia, and occasionally psychoses with hallucinations and agitation.

amphetamine sulfate

Examples of this class include (?) (the prototype) and dextroamphetamine (Dexedrine).

Methylphenidate

(?); marketed as Ritalin, is the most commonly prescribed medication for attention deficit hyperactivity disorder (ADHD).

pharmacologic mechanism of action

Although it is chemically different from the amphetamines, its (?) is similar.

Class II controlled substance

Also, like the amphetamines, it has a high abuse potential and is therefore listed as a (?).

stimulant

Although treating hyperactivity with a (?) can seem odd, it is quite effective.

inability to concentrate or focus

Frequently, the cause of inappropriate behavior in children with ADHD is their (?).

Ritalin’s stimulant effects

(?) increase this ability, and the unwanted behavior often diminishes.

methylxanthines

The (?) include caffeine, aminophylline, and theophylline.

caffeine

Although (?), the prototype medication in this class, has few clinical uses, it is frequently ingested in coffee, colas, and chocolates.

bronchial smooth muscle

Theophylline’s relaxing effects on (?) make it helpful in treating asthma.

adenosine receptors

The mechanism of action of methylxanthines is unclear, but it seems to block (?).

endogenous neurotransmitter

Adenosine is an (?) that is used clinically for certain types of tachycardias.

larger-than-normal doses

Because methylxanthines block the adenosine receptors, (?) could be needed to achieve the desired result.

lower potential for abuse

The side effects of this class are similar to those of the amphetamines, but the methylxanthines have a much (?) and are not controlled medications.