Ch. 4 Pharm: Sedative-Hypnotics & ADHD Agents

Question 1

Sedative-Hypnotics: Background Assessment data = indications

Answer 1

-Indications: short term management of various anxiety states and treatment of insomnia;
- selected agents are used as anticonvulsants, as preoperative sedatives, and to reduce anxiety associated with alcohol withdrawal

Question 2

Sedative-Hypnotics: Background Assessment data = Action

Answer 2

• Depression of the CNS
• Exceptions: Ramelton’s sleep-promoting properties are the result of agonist activity on selective melatonin receptors

Question 3

List of Sedative-Hypnotics: Not tested on, but helpful, Heres 3 of the many on that slide

Answer 3

• Temazepam (Restoril)
• Triazolam (Halcion)
• Zolpidem (Ambien)

Question 4

Sedative-Hypnotics: contraindicated

Answer 4

Allergic, Pregnant, lactation, severe hepatic, cardiac, respiratory, or renal disease

Question 5

Sedative-Hypnotics: caution

Answer 5

Those who are suicidal or who are addicted to drugs

Question 6

Sedative-Hypnotics: S/E

Answer 6

• Drowsiness & confusion
• Lethargy
• tolerance
• Dependance
• hypotension
• Abnormal thinking and behavioral changes

Question 7

ADHD Agents: Action of stimulants

Answer 7

• The CNS stimulants (Amphetamines, methylphenidate) increase levels of norepinephrine, dopamine, and serotonin in the CNS
• Their effectiveness in the treatment of ADHD is thought to be based on the activation of dopamine D4 receptors, which depress motor activity

Question 8

ADHD Agents: Action of Non-stimulants

Answer 8

• Atomoxetine (straterra) inhibits the reuptake of norepinephrine and bupropion (wellbutrin) blocks the neuronal uptake of serotonin, norep., and dopamine
• Clonidine and Guanfacine stimulate central alpha-adrenergic receptors in the brain resulting in reduced sympathetic outflow from the CNS.
• The exact mechanism by which these non-stimulant drugs produce the therapeutic effect in ADHD is unclear

Question 9

ADHD Agents: Contraindications of Stimulants

Answer 9

• Allergic to sympathomimetic amines
• clients with advanced ateriosclerosis
• cardio disease, hyper tn, hyperthyroidism, glaucoma
• agitated or hyperexcitablity states, hist of drug abuse
• MAOIs within 14 days of use, and under 3 yrs old

Question 10

ADHD Agents: Contraindications of Atomoxetine and Bupropion

Answer 10

Contraindicated in clients with hypersensitivity to the drugs, in lactation, and in concomitant use with or within 2 weeks of using MAOIs.

Question 11

ADHD Agents: Contraindications of Bupropion

Answer 11

Seizure disorders, acute MI, bulimia or anorexia nervosa.

Question 12

ADHD Agents: Contraindications of Alpha Agonists

Answer 12

allergies to it

Question 13

ADHD Agents: precautions for stimulants

Answer 13

• Children, tourette’s, anorexia, insomnia,
• Hist of suicide, homicidal tendencies
• elderly
• Prolonged use may result in tolerance

Question 14

ADHD Agents: Precautions for Atomoxeline and bupropion

Answer 14

urinary retention, hepatic, renal, cardio disease, suicidal clients, pregnant, elderly

Question 15

ADHD Agents: Precautions for Alpha agonists

Answer 15

Coronary insufficiency, recent MI, cerebrovascular disease, renal/hepatic failure,

Question 16

ADHD Agents: Many S/E…some to note

Answer 16

• Overstimulation, insomnia
• palpitations, tachycardia
• Anorexia, weight loss
• N/V
• Sedation or rebound syndrome (alpha agonists)