Chapter 17 : Stimulants

Question 1

What do we use stimulants for?

Answer 1

ADHD
Narcolepsy
Reversal of respiratory distress

Question 2

Normally why or who do we usually use reversal of respiratory distress CNS stimulants?

Answer 2

For pre terms babies because they forget to breathe

Question 3

What of medication of stimulant do we usually for our pre term babies?

Answer 3

Analeptics, caffeine

Question 4

What are the 3 categories we are going to talk about for CNS stimulant?

Answer 4

Amphetamines
Analeptics, caffeine
Anorexiants

Question 5

What does amphetamines act on?

Answer 5

In the cerebral cortex

Question 6

What does Analeptics, caffeine act on?

Answer 6

Brain stem and medulla

Question 7

What does anorexiants act on?

Answer 7

On satiety center in hypothalamic and limbic areas

Question 8

What is narcolepsy?

Answer 8

Recurrent attacks or drowsiness and sleep during normal waking activities

Like driving and talking

When you’re not suppose to be falling asleep or trying to fall asleep

Question 9

Amphetamines topic!!

Question 10

What is the action of amphetamines?? (2)

Answer 10

Stimulate release of norepinephrine and dopamines

Block reuptake of norepinephrine and dopamines

Question 11

What are the 4 amphetamines CNS effects?

Answer 11

Mood elevation / euphoria

Increase mental alertness and capacity for work

Decreased fatigue and drowsiness

Prolonged wakefulness

Question 12

What are the 3 respiratory effects of amphetamines ?

Answer 12

Relaxation of bronchial smooth muscle

Increase respiration

Dilation of pulmonary arteries

Question 13

If you stop your ADHD medications what happens?

Answer 13

You feel exhausted for a while

Question 14

Normally we recommended patients to slowly tapper off ADHD why?

Answer 14

To not feel so exhausted

Question 15

Is amphetamines a long acting pill?

So we recommend they take it during?

Answer 15

Yes

The morning so it’s out of your system when it’s time for sleep

Question 16

What are the adverse effects of amphetamines? (8)

Answer 16

Palpitations
Tachycardia
Hypertension
Nervousness
Restlessness
Insomnia
Anoriexa( not being hunger )
Growth suppression

Question 17

Think of the fact that amphetamines is a stimulant so you’re over stimulant, so think of?

Answer 17

Like cardiac
You are feeling too much
Jumpy
Uncomfortable
Can’t sit still

Question 18

Excess use of amphetamines what happens?

Answer 18

Psychosis

( This medication is psychosis based so when you’re off of it, you shouldn’t be at this risk anymore )

Question 19

Amphetamines causes what type of weight ?

Answer 19

Weight loss appetite suppression

Decrease appetite = weight loss
Because they have upset stomach

Usually a lot of kids
End up getting

Growth suppression

Question 20

Some doctors will do a baseline of what before starting amphetamines ( ADHD meds )?

Answer 20

Heart
To see what they are before

Question 21

Amphetamines, you always want to get these people a good diet like what? Because they aren’t hungry ^

Answer 21

Protein
Yogurt
Fruits and vegs

Question 22

What are the 2 drugs for amphetamines - like drugs for ADHD?

Answer 22

Methylphenidate

Dexmethylphenidate

Question 23

What the function of the 2 ADHD medications?

Answer 23

Increase attention span and cognitive performance

Memory and reading

Decrease impulsiveness, hyperactivity and restless

Question 24

What are the 3 big concerns for amphetamine drugs?

Answer 24

Sleep
Growth suppression
Cardiac

Question 25

What does narcolepsy drugs do?

Answer 25

Increase wakefulness in patients with sleep disorders

Question 26

Narcolepsy drugs do
Increase effects of ? (4)
Decrease effects of?

Answer 26

Anticoagulants, anticonvulsants, TCAS, MAOIS
Antihypertensives

Question 27

Nursing implications of ADHD
Last daily dose should be given what?
Take on an ____stomach at what time?
Eat a healthy ___

Monitor child for
Physical growth, including height and weight

Answer 27

4-6 hours before bedtime
Empty- 30-45mins before meals
Breakfest

Question 28

Notes
Amphetamine
Usually contraindicated in heart disease, hypertension, hyperthyroidism, Parkinsonism, glaucoma

Assses vital signs, monitor for increase in BP

Assess mental status, such as mood, affect and aggressiveness

Don’t discontinue suddenly

Assess complete blood count
Differential white blood cells
Platelets before and during therapy

Sugarless gum for dry mouth

Question 29

If you think of hyperthyroid, has the same side effects of amphetamines, so we what?

Answer 29

Don’t give that medication to treat hyperthyroid

Question 30

Anorexiants

Question 31

What does Anorexiants do?

Answer 31

Appetite suppression
- cause stimulant effect on hypothalamic and limbic areas of brain

Question 32

At what age should we not give Anorexiants?

Answer 32

Under 12 year old

Question 33

What are your side effects if Anorexiants?

Answer 33

Restlessness
Euphoria
Insomnia
Tachycardia
Palpitations
Hypertension
Seizures
Erectile dysfunction

Question 34

Analeptics

Question 35

What is analeptics, caffeine used for?

Answer 35

Used for neonatal apnea
Used for mental alertness

Question 36

What are your 6 analeptics side effects?

Answer 36

Palpitations
Tachycardia
Dysrthymias
Insomnia
Tremors
Restlessness

Question 37

Practice question 1
What would indicate to the nurse that the child taking methylphenidate requires more teaching?

A. The child is seen drinking a cold product

B. The child checks his weight twice a week

C. The child takes the drug 45mins before a meal

D. The child takes the drug before breakfast and lunch

Answer 37

A.The child is seen drinking a cold product

Question 38

Practice question 2
A child has been diagnosed with ADHD. Which drug dose the nurse anticipate the health care provider will prescribed?

A. Zolmitriptan
B. Doxapram
C. Benzphetamine
D. Methylphenidate

Answer 38

D. Methylphenidate

Question 39

Practice question 3
Methylphenidate should not be taken by patients with a history of which condition?

A. Renal failure
B. Glaucoma
C. Hypothyroidism
D. Heart disease

Answer 39

D. Heart disease