CNS Stimulants

Exam #6

Prototype of Amphetamine Sulfate

Methylphenidate

MOA of Methylphenidate

Stimulate areas of the brain associated with mental alertness

Use of Methylphenidate

• ADHD

• Narcolepsy (daytime sleepiness, sudden sleep attacks)

• Obesity

Contraindications of Methylphenidate

• Cardiac structural abnormalities

• Recent MAOI use

Side Effects of Methylphenidate

• Wide range (dose related)

• Tend to “speed up” body systems

• Common adverse effects:

  • Palpitations

  • Tachycardia

  • Hypertension

  • Dysrhythmias (irregular heart rhythms)

  • Angina (chest pain)

Nursing Implications of Methylphenidate

Controlled substance

Non-Stimulant Drug

Atomoxetine

Purpose of Atomoxetine

• Increases availability

• Effect of norepinephrine

Route of Atomoxetine

PO

Indication of Atomoxetine

ADHD

Complication of Atomoxetine

• Weight loss

• Nausea

• Vomiting

• Anorexia

• Growth suppression (slower than expected growth)

• Suicide thoughts

Nursing Implications of ADHD Drugs

• Last daily dose should be given 4-6 hours before bedtime to reduce insomnia

• Take on an empty stomach 30-45 minutes before meals

• Drug “holidays” may be ordered (not taking meds)

• Instruct parents to keep a journal to monitor the child’s response to therapy

• Monitor the child for continued physical growth, including height and weight

• Monitor for therapeutic responses

  • ADHD: Decreased hyperactivity, increase attention span and concentration