CNS Stimulants and Related Drugs – Key Vocabulary

A comprehensive set of vocabulary flashcards covering key terms, drugs, mechanisms, indications, contraindications, adverse effects, and nursing considerations related to CNS stimulants and associated therapies.

Central Nervous System (CNS)

Brain and spinal cord; target or source of most stimulant drug actions and adverse effects.

Excitatory Neurotransmitter

Chemical (e.g., dopamine, norepinephrine, serotonin) that increases neuronal activity in the CNS.

Dopaminergic Drug

Medication that stimulates dopamine receptors to raise CNS activity (e.g., amphetamines).

Adrenergic Drug

Agent that stimulates norepinephrine receptors, producing sympathomimetic CNS effects.

Serotonergic Drug

Drug that acts on serotonin receptors; includes migraine medicines called triptans.

Sympathomimetic Drug

Substance that mimics sympathetic nervous system activity; many CNS stimulants belong here.

CNS Stimulant

Drug that increases neuronal activity in selected brain/spinal cord areas, improving alertness or respiration.

Amphetamine (Class)

Powerful CNS stimulants that elevate mood, alertness, and wakefulness; treat ADHD and narcolepsy.

Xanthine (Class)

Naturally occurring stimulants (e.g., caffeine, theophylline) that enhance respiration via phosphodiesterase inhibition.

Attention-Deficit/Hyperactivity Disorder (ADHD)

Common childhood psychiatric disorder marked by inattention, hyperactivity, and impulsivity.

Narcolepsy

Incurable neurologic disorder characterized by unexpected "sleep attacks" during daytime activities.

Cataplexy

Sudden skeletal-muscle weakness often accompanying narcolepsy episodes.

Obesity

Medical condition defined by BMI ≥ 30 and associated with multiple health risks.

Body Mass Index (BMI)

Weight-for-height index; 25–29.9 = overweight, ≥ 30 = obese.

Migraine

Recurring unilateral or bilateral pulsating headache lasting 4–72 h with nausea, photophobia, & phonophobia.

Photophobia

Sensitivity or avoidance of light, commonly accompanying migraines.

Phonophobia

Sensitivity or avoidance of sound, often present during migraine attacks.

Analeptic

Drug that stimulates CNS areas controlling respiration; used for neonatal apnea or post-anesthetic depression.

Theophylline

Methylxanthine analeptic used to stimulate breathing in neonatal apnea and COPD.

Aminophylline

IV pro-drug of theophylline providing respiratory stimulation.

Caffeine (Pharmacologic)

Methylxanthine CNS stimulant found in beverages, OTC NoDoz, and prescription combos (Fioricet/Fiorinal).

Doxapram (Dopram)

IV analeptic for respiratory depression or COPD hypercapnia; requires reflex monitoring.

Methylphenidate (Ritalin)

First-line stimulant for ADHD and narcolepsy; available in multiple extended-release forms.

Modafinil (Provigil)

Schedule IV non-amphetamine that promotes wakefulness in narcolepsy and shift-work sleep disorder.

Armodafinil (Nuvigil)

R-enantiomer of modafinil with similar wake-promoting effects and low abuse potential.

Atomoxetine (Strattera)

Non-stimulant norepinephrine reuptake inhibitor for ADHD; carries warning for suicidal thoughts in adolescents.

Lisdexamfetamine (Vyvanse)

Pro-drug converted to dextroamphetamine; treats ADHD with lower abuse risk.

Mechanism of Amphetamines

Increase synaptic dopamine & norepinephrine, elevating mood, alertness, and capacity for work.

Respiratory Effects (Amphetamines)

Bronchodilation, increased respiratory rate, and pulmonary artery dilation.

Recent MAOI Usage

Contraindication to stimulants due to risk of hypertensive crisis.

Amphetamine Adverse Effects

Palpitations, tachycardia, hypertension, insomnia, anxiety, nausea, diarrhea, dry mouth, urinary frequency.

Phentermine (Ionamin)

Sympathomimetic anorexiant structurally related to amphetamines but with lower abuse potential.

Benzphetamine (Regimex)

Prescription anorexiant approved for short-term obesity management.

Methamphetamine (Desoxyn)

Controlled anorexiant/stimulant reserved for refractory obesity; high abuse potential.

Diethylpropion (Tenuate)

Appetite-suppressant anorexiant approved for weight loss therapy.

Anorexiant Mechanism

Suppress hypothalamic appetite center, increase basal metabolic rate, mobilize fat, and reduce fat absorption.

Orlistat (Xenical)

Non-stimulant obesity drug that inhibits intestinal lipase, preventing ~30 % of dietary fat absorption.

Qsymia

Combination of phentermine and topiramate used to aid chronic weight management.

Contrave ER

Extended-release naltrexone and bupropion formulation for weight loss.

Saxenda (Liraglutide)

GLP-1 agonist injectable for obesity; marketed as Victoza for type 2 diabetes.

Triptan

Selective serotonin (5-HT1) receptor agonist that aborts acute migraine by cranial vasoconstriction.

Sumatriptan (Imitrex)

Prototype triptan available PO, SC, and nasal spray for rapid migraine relief.

Ergot Alkaloid

Older migraine therapy that constricts cerebral vessels; includes ergotamine and D.H.E. 45.

Dihydroergotamine Mesylate

Injectable or nasal ergot alkaloid (Migranal) for acute migraine treatment.

Ergotamine Tartrate with Caffeine (Cafergot)

Tablet combining ergotamine and caffeine to treat migraines.

Calcitonin Gene-Related Peptide (CGRP) Inhibitor

Injectable or oral monoclonal antibody/antagonist class for migraine prevention or acute treatment.

Onabotulinumtoxin A (Botox)

Injected every 12 weeks for chronic migraine; BBW for systemic toxin spread.

Triptan Adverse Effects

Tingling, flushing, injection-site irritation, and potential dangerous hypertension.

Ergot Adverse Effects

Nausea, vomiting, cold extremities, muscle pain, dizziness.

Analeptic Mechanism (Methylxanthines)

Phosphodiesterase inhibition → ↑ cAMP → CNS respiratory stimulation.

Caffeine Contraindications

Use cautiously with peptic ulcer, recent MI, or dysrhythmias due to stimulant effects.

Doxapram Indication

Respiratory depression from anesthesia, drug overdose, or COPD with hypercapnia.

Drug Holiday

Planned break from stimulant therapy to reduce tolerance and assess ongoing ADHD need.

ADHD Dosing Timing

Give last stimulant dose 4–6 h before bedtime; take 30–45 min before meals on empty stomach.

Anorexiant Caffeine Avoidance

Patients must eliminate caffeine to reduce additive stimulant effects and insomnia.

Vitamin Supplementation with Orlistat

Fat-soluble vitamins (A, D, E, K) may be needed because drug blocks fat absorption.

Serotonin Receptor Agonist Forms

Available as dissolvable wafers, nasal sprays, and self-injectables for migraine self-management.

Amphetamine Examples

Dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, amphetamine aspartate (Adderall).

Atomoxetine Black Box Warning

Risk of suicidal ideation in pediatric/adolescent ADHD patients; requires close monitoring.

Schedule IV Drug

Federal classification for modafinil/armodafinil due to low but present abuse potential.

Analeptic Vagal Effects

May increase gastric secretions, cause diarrhea, and reflex tachycardia.

Anorexiant Indications

Adjunct to diet & exercise for weight loss, typically restricted to higher-risk obese patients.

Hypertension Risk with Triptans

Serotonin agonists can significantly raise BP; contraindicated in uncontrolled hypertension.

Lipase

Intestinal enzyme inhibited by Orlistat to block dietary fat breakdown and absorption.

Basal Metabolic Rate (BMR)

Energy expenditure at rest; anorexiants increase it to aid weight loss.

Cyclic Adenosine Monophosphate (cAMP)

Intracellular messenger elevated by methylxanthines, leading to respiratory stimulation.

Phosphodiesterase Inhibition

Mechanism whereby xanthines prevent cAMP breakdown, boosting CNS activity.

5-HT1 Receptor

Serotonin receptor subtype stimulated by triptans to constrict cerebral vessels.

Abortive Migraine Therapy

Treatment given during migraine aura/onset to stop headache progression (e.g., triptans).

Vasoconstriction (Triptans)

Narrowing of cerebral arteries that relieves migraine pain but may raise blood pressure.

Botox Black Box Warning

Potential spread of botulinum toxin beyond injection site causing swallowing or breathing problems.

Self-Injectable Triptan

Sumatriptan SC formulation allowing patients rapid at-home migraine relief.

Neonatal Apnea

Breathing pauses in premature infants; often treated with caffeine or theophylline.

COPD-Induced Hypercapnia

Elevated CO₂ in COPD patients; doxapram may stimulate ventilation.

Sympathomimetic Anorexiant

Appetite suppressant that activates adrenergic pathways (e.g., phentermine).