CNS Stimulants/Drugs of Abuse Flashcards
(28 cards)
Patho of ADHD (3)
- Psychiatric condition developing in childhood characterized by:
1. Inattention (formally ADD)
2. Hyperactivity/Impulsivity
3. A combo of both
Agents of ADHD (3)
Amphetamines
- Amphetamine (Adderall)
Amphetamine-Like Drugs
- Methylphenidate (Ritalin)
Non-stimulants
- Atomoxetine
Amphetamine (Drug, Used for, Action)
Drug: Adderall
Used for: ADHD & Narcolepsy
Action: increase dopamine and norepinephrine (central & peripheral) by reversing the transporter and inhibiting storage
Amphetamine (Physiological effects [4] and Problems with these effects)
Physiological Effects:
- Increased focus, wakefulness, mood, and initiative
-Reduced appetite
- Sympathetic effects (heart)
- Tolerance
Problems with these effects: Physical dependence and High potential for abuse
Amphetamine (ADRs [4])
ADRs:
- Insomnia, restlessness (take during day)
- Weight loss (suppresses appetite; take after eating breakfast)
- Dangerous CV effects w/ pre-existing heart conditions (baseline ECG may be warranted)
- Paranoid psychosis (vivid nightmares/paranoia; discontinue meds)
Amphetamine (Intensity based on the molecular structure [5])
Adderall: mixture of Dex and Levo
- Dextroamphetamine (more potent)
- Levoamphetamine (less potent)
- Lisdexamfetamine (pro drug [Vyvanse]; can’t get high off this)
-Methamphetamine
Amphetamine-Like Agents (Drugs, Used for, Action/ADRs/Nursing Implications)
Drug: Methylphenidate (Ritalin, Concerta)
Used for: First line agent in ADHD, also used in narcolepsy
Action/ADRs/Nursing Implications:
- Same as amphetamines, w/ a different chemical structure
- Methylphenidate is a 50:50 mixture (dextro and levo)
-The active isomer is Demethylphenidate
Non-Stimulants (Drug, Used for, Action)
Drug: Atomoxetine
Used for: Second line therapy if stimulants fail
Action: Increase norepinephrine by selectively inhibiting reuptake
Atomoxetine (ADRs)
- GI upset
- Reduced appetite, dizziness, somnolence (tired), mood swings
Atomoxetine (Nursing Implications)
- Notify HCP and discontinue drug if allergic reaction develops
- Young pts should be monitored for suicidal ideation
Agents for ADHD (Drug Interactions)
-MAOI: hypertensive crisis
–> Prevents breakdown of NOR
- 3 weeks recommended b/w agents
Other Stimulants (Drug, Used for [3])
Drug: Methylxanthine’s (Caffeine, Theophylline
Used for:
- Neonatal apnea (hard time breathing)
- Promoting wakefulness
- Alleviating headache
Caffeine (Action [3])
- Adenosine receptor antagonist (promotes wakefulness)
- Inhibits phosphodiesterase (dilates bronchial smooth muscle)
- Increases NOR and Dopamine release (stimulates the CNS)
Caffeine (ADRs [3])
- Tolerance (avoid drinking everyday)
- Cardiovascular Stimulation (discontinue)
- Convulsions (overdose)
What drugs are Psychostimulant?
- Cocaine
- Methamphetamine
- MDMA (Ecstasy or Mollie)
Cocaine (Action)
- Blockade of Na channels
- Blockade of reuptake of NOR, dopamine, and serotonin
Cocaine (effects)
- Local anesthesia (blocks Na channels so it blocks perception of pain)
- Vasoconstriction
- Cardiac stimulation
- Agitation
- Rebound congestion: runny/leaky nose
Methamphetamine (Action)
- Increase NE and DA release for wakefulness, elevated mood, increased physical and mental capacity
Amphetamine (effects)
- Increased wakefulness, focus, mood, and initiative
- Agitation, Nervousness, Paranoia
- Reduced appetite
- Rapid aging
- Tooth decay
- Sympathetic effects
- Tolerance
What happens when you take a low dose of MDMA?
- Mild LSD-like psychologic effects
What happens when you take a high dose of MDMA?
- Amphetamine-like effects
(awake longer = party longer)
What is the 2 drugs are structurally related to MDMA?
- Amphetamines and mescaline
MDMA (effects)
- Injury of serotonergic neurons
- Stimulate the heart, and dangerously raise body temp.
- Seizures, spasmodic jerking, jaw clenching, teeth grinding
- Confusion, anxiety, paranoia, panic
What are Psychostimulants signs of acute toxicity?
- Agitation, tremor, dysrhythmias, stroke, hallucinations, paranoia, convulsions
