Chap 13 - Pharmacology of Amphetamines, Caffeine, Methylphenidate & Sumatriptan: MOA, AEs, Contraindications

What are amphetamines used for?

ADHD treatment, Narcolepsy, Short‑term obesity treatment, and occasionally in treatment‑resistant depression, though not commonly used.

What is Amphetamine's MOA?

Increase dopamine, norepinephrine, serotonin by release & reuptake inhibition.

What are the common adverse effects of amphetamines?

Insomnia, appetite suppression, restlessness.

Amphetamines Serious adverse effects

Hypertension, arrhythmias, hyperthermia, seizures, psychosis.

What are amphetamines' contraindications?

Use of MAOIs within 14 days, severe hypertension, heart disease, hyperthyroidism, drug‑abuse history, agitation

What safety concern is associated with amphetamine misuse?

High potential for addiction, overdose, and stimulant‑induced psychosis

What is caffeine's MOA?

It blocks adenosine receptors (antagonist), increasing alertness and reducing fatigue

What are caffeine's common adverse effects?

Restlessness, insomnia, increased urination, GI upset, tremor and headache

What are caffeine's serious adverse effects?

Arrhythmias, seizures, severe hypertension (esp. w/ MAOIs).

What are caffeine's contraindications?

MAOI use, pregnancy cautions, anxiety, GI issues.

What effect does caffeine have on the bladder?

Irritates bladder → urgency.

What is methylphenidate used for?

ADHD, narcolepsy, pediatric adhd

What is methylphenidate's MOA?

It blocks dopamine and norepinephrine reuptake to increase CNS stimulation

What are methylphenidate's cardiovascular adverse effects?

Stroke, MI, sudden death in at-risk patients.

What are methylphenidate's psychological adverse effects?

Psychosis, irritability, aggression.

Methylphenidate Contraindications

MAOI use <14 days, glaucoma, severe hypertension, tics, anxiety.

What are the cautions of methylphenidate in pediatric patients?

Risk of weight loss and slowed growth; requires growth monitoring.

What is sumatriptan's MOA?

It is a 5‑HT₁B/₁D receptor agonist causing cranial vasoconstriction and reduced trigeminal pain signaling

What are the common adverse effects of sumatriptan?

Chest pressure, tingling, flushing, dizziness.

What are the serious sumatriptan adverse effects?

Coronary vasospasm, MI, arrhythmias, serotonin syndrome.

Sumatriptan Contraindications

Heart disease, uncontrolled hypertension, basilar/hemiplegic migraine.

What is sumatriptan used for?

Use for acute migraine only; best early in attack.

A patient diagnosed with narcolepsy is prescribed a central nervous system (CNS) stimulant. Which statement best describes the action of CNS stimulants?

CNS stimulants increase release of and block reuptake of neurotransmitters.

Which patient assessment finding noted in a patient's medical history, would alert the nurse to be concerned with use of prescribed caffeine?

Cardiac dysrhythmias

A nurse working with patients who are diagnosed with attention deficit hyperactivity disorder (ADHD) is aware that such patients often take central nervous system (CNS) stimulant drugs increasing the risk for abuse and dependence. Based on this potential, how are these medications classified?

Schedule II

A patient diagnosed with narcolepsy is prescribed methylphenidate. Which adverse effects would the nurse include when teaching about this drug?

insomnia, headache, weightloss