CNS Stimulants

ADHD

Inattention

Attention-Deficit/Hyperactivity Disorder

Full meaning of ADHD

Serotonin

Neurotransmitter associated with ADHD and brain signaling

Norepinephrine

Neurotransmitter involved in attention and alertness

Dopamine

Neurotransmitter involved in attention and motivation

Narcolepsy

Falling asleep during normal waking activities

CNS stimulants

Drug class of amphetamines

9–15 hours

Half-life of amphetamines

Norepinephrine and dopamine

Neurotransmitters released by amphetamines

Block reuptake

Action of amphetamines on neurotransmitter reuptake

Increase release and block reuptake

Two main actions of amphetamines

Amphetamine sulfate

Example of an amphetamine drug

Dextroamphetamine sulfate

Example of an amphetamine drug

Lisdexamfetamine dimesylate

Example of an amphetamine drug

Amphetamine + dextroamphetamine

Example of an amphetamine drug

Morning/upon awakening

Best time to take amphetamines

Insomnia

Reason amphetamines should not be taken at bedtime

Korean ginseng and St. John’s wort

Substances to avoid with amphetamine-like drugs

Modafinil

Drug that increases wakefulness in narcolepsy

Increased wakefulness

Main effect of modafinil

Not fully known

Mechanism of action of modafinil

GI mucosa

Absorption site of methylphenidate

Twice daily

Common frequency of methylphenidate administration

Before breakfast and lunch

Common timing of methylphenidate doses

Food

Factor that affects methylphenidate absorption rate

Upon awakening or 30–45 minutes before meals

Recommended timing of methylphenidate

6 hours

Minimum time methylphenidate should be given before sleep

Insomnia

Side effect requiring early dosing of methylphenidate

Urine

Primary route of methylphenidate excretion

40%

Percentage of methylphenidate excreted unchanged

ADHD and narcolepsy

Two conditions treated with methylphenidate

CNS stimulant/psychostimulant

Drug class of methylphenidate

Increased stimulation

Effect of methylphenidate with other CNS stimulants

Irritability

nervousness

Hypertensive crisis

Serious reaction to methylphenidate + MAOI

Potentiates their action

Effect of methylphenidate on CNS stimulants

Phenobarbital

Barbiturate mentioned in methylphenidate interactions

Inhibits metabolism

Effect of methylphenidate on phenobarbital metabolism

Increased phenobarbital levels/toxicity

Result of inhibited phenobarbital metabolism

Anorexiants

CNS stimulants that suppress appetite

Appetite suppression

Main effect of anorexiants

Hypothalamic and limbic regions

Brain regions stimulated by anorexiants

Avoid reliance

Recommended approach to appetite suppressants

Healthcare provider

Person who should supervise anorexiant use

Hypertension

hyperthyroidism

14 days

MAOI waiting period for anorexiants

Diabetes

seizures

Under 12 years old

Age contraindication listed for anorexiants

Stimulate respiration

Primary purpose of analeptics

Xanthines/methylxanthines

Subgroup of analeptics

4 hours

Approximate half-life of methylxanthines

Liver disease and oral contraceptives

Conditions that prolong methylxanthine half-life

Contraindicated

Pregnancy status of methylxanthines in the notes

Unknown fetal effects

Reason methylxanthines are contraindicated during pregnancy