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Flashcards in CNS Stimulants and Related Drugs Deck (15):
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Methylphenidate (Ritalin)
(Functional Classification)

Cerebral Stimulant

1

Methylphenidate (Ritalin)
(Chemical Classification)

Piperdine derivative

2

Methylphenidate (Ritalin)
Mechanism of Action

Increases release of norepinephrine, dopamine in cerebral cortex to reticular activating system; exact action not known

3

Methylphenidate (Ritalin)
(Uses)

Attention Deficit Disorder (ADD), attention-deficit/hyperactivity disorder (ADHD); narcolepsy (except Concerta, Metadate CD, Ritalin LA)

4

Methylphenidate (Ritalin)
(Contraindications)

Children s syndrome; glaucoma, anorexia nervosa, tartrazine dye hypersensitivity

5

Methylphenidate (Ritalin)
(Side Effects)

CNS: Hyperactivity, Insomnia, Restlessness, Talkativeness, dizziness, drowsiness, toxic psychosis, headache, akathisia, dyskinesia, masking or worsening of Gilles de la Tourette's syndrome, SEIZURES, hallucinations, MALIGNANT NEUROLEPTIC SYNDROME, aggression; CEREBRAL VASCULITIS, HEMORRHAGE, STROKE (RARE)
CV: Palpitations, Tachycardia, BP changes, angina, DYSRHYTHMIAS
ENDO: growth retardation
GI: nausea, anorexia, dry mouth, weight loss, abdominal pain
HEMA: LEUKOPENIA, ANEMIA, THROMBOCYTOPENIC PURPURA
INTEG: EXFOLIATIVE DERMATITIS, urticaria, rash, erythema multiforme, HYPERSENSITIVITY REACTIONS
MISC: fever, arthralgia, scalp hair loss



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Methylphenidate (Ritalin)
(Nursing Considerations)

ASSESS:
-ADHD: attention span, decreased hyperactivity
-VS, BP; may reverse antihypertensives; check patients with cardiac disease more often for increased BP
-CBC with differential, platelets, LFTs, urinalysis; in diabetes: blood glucose, urine glucose; insulin changes may have to be made because eating will decrease
-Height, growth rate q3mo in children; growth rate may be decreased
-Mental status: mood, sensorium, affect, stimulation, insomnia, aggressiveness
-WITHDRAWAL SYMPTOMS: headache, nausea, vomiting, muscle pain, weakness
-Appetite, sleep, speech patterns
-NARCOLEPSY: identify frequency, length of narcoleptic episodes

7

Methylphenidate (Ritalin)
(Overdose Treatment)

Administer fluids; hemodialysis or peritoneal dialysis; antihypertensive for increased BP; administer short-acting barbiturate before lavage

8

Sumatriptan (Imitrex)
(Functional Classification)

Antimigraine Agent

9

Sumatriptan (Imitrex)
(Chemical Classification)

5-HT1B/D receptor agonist, abortive agent, triptan

10

Sumatriptan (Imitrex)
(Mechanism of Action)

Binds selectively to vascular 5-HT1B/D receptor subtype, exerts antimigraine effect; causes vasoconstriction in cranial nerves

11

Sumatriptan (Imitrex)
(Uses)

Acute treatment of migraine with/without aura and cluster headache

12

Sumatriptan (Imitrex)
(Contraindications)

Angina pectoris, history of MI, documented silent ischemia, Prinzmetal's angina, ischemic heart disease, IV use, concurrent ergotamine-containing preparations, uncontrolled hypertension, hypersensitivity, basilar or hemiplegic migraine

13

Sumatriptan (Imitrex)
(Side Effects)

CNS: Tingling, Hot Sensation, Burning, Feeling of Pressure, Tightness, Numbness, Dizziness, Sedation, headache, anxiety, fatigue, cold sensation
CV: Flushing, MI, hypo/hypertension
EENT: throat, mouth, nasal discomfort; vision changes
GI: abdominal discomfort
INTEG: Inj site reaction, sweating
MS: Weakness, Neck Stiffness, myalgia
RESP: chest tightness, pressure

14

Sumatriptan (Imitrex)
(Nursing Considerations)

ASSESS:
-MIGRAINE: type of pain, aura; alleviating, aggravating factors; sensitivity to light, noise
-SEROTONIN SYNDROME: delirium, coma, agitation, diaphoresis, hypertension, fever, tremors; may resemble neuroleptic malignant syndrome in patients taking SSRIs, SNRIs
-BP, signs, symptoms of coronary vasospasms, ECG
-Tingling, hot sensation, burning, feeling of pressure, numbness, flushing, inj site reaction
-Stress level, activity, reaction, coping mechanisms
-Neurologic status: LOC, blurring vision, nausea, vomiting, tingling in extremities preceding headache
-Ingestion of tyramine foods (pickled products, beer, wine, aged cheese), food additives, preservatives, colorings, artificial sweeteners, chocolate, caffeine, which may precipitate these types of headaches
-Renal function, urine output

PERFORM/PROVIDE
-Quiet, calm environment with decreased stimuli: noise, bright light, excessive talking