1. Copyright © 2008 Lippincott Williams & Wilkins. Introductory Clinical Pharmacology Chapter 25 Central Nervous System Stimulants

2. Copyright © 2008 Lippincott Williams & Wilkins. Medications to Recognize: CNS Stimulants Analeptics –Increase depth of respirations by stimulating receptors that measure amount of oxygen in blood Ex :Caffeine

3. Copyright © 2008 Lippincott Williams & Wilkins. CNS stimulants: Actions (cont’d) Amphetamines –Elevate blood pressure; wakefulness; increase or decrease pulse rate; produce euphoric state Ex: Adderall, methylphenidate (Ritalin) Anorexiants –Suppress appetite Ex: sibutramine (Meridia)

4. Copyright © 2008 Lippincott Williams & Wilkins. CNS Stimulants: Uses CNS stimulants as treatment for: –Attention deficit hyperactivity disorder; drug-induced respiratory depression; postanesthesia respiratory depression without reduction of analgesia; narcolepsy; sleep apnea; obesity; fatigue

5. Copyright © 2008 Lippincott Williams & Wilkins. CNS Stimulants: Adverse Reactions Neuromuscular reactions –Excessive CNS stimulation; headache; dizziness; apprehension; disorientation; hyperactivity Other –Nausea; vomiting; cough; dyspnea; urinary retention; tachycardia; palpitations

6. Copyright © 2008 Lippincott Williams & Wilkins. CNS Stimulants: Contraindications CNS stimulants contraindicated in patients with known hypersensitivity; convulsive disorders; ventilation mechanism disorders Nurse should not administer CNS stimulants to patients with cardiac problems; severe hypertension;

7. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Assessment Preadministration assessment –Respiratory depression Initial assessments: Blood pressure, pulse, respiratory rate Note depth of respirations and any pattern to respiratory rate Review recent laboratory test results

8. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Assessment Preadministration assessment (cont’d) –Attention deficit hyperactivity disorder Amphetamine prescribed: Weigh patient and take blood pressure, pulse, and respiratory rate Child with ADHD: Observe for patterns of abnormal behavior Record summary: Document/chart client’s behavior to provide comparison and help identify future changes

9. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Assessment Preadministration assessment (cont’d) –Obesity Anorexiant or amphetamine used for outpatient use Obtain and record blood pressure, pulse, respiratory rate, weight – before therapy starts and at each outpatient visit

10. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Implementation Monitoring and managing patient needs –Disturbed sleep patterns CNS stimulant therapy: Causes insomnia Avoid coffee, tea, cola drinks Administer during day time

11. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Evaluation Child’s behavior, school performance improve Weight loss is achieved Respiratory depression: Reversed Fewer episodes of inappropriate sleep patterns reported Adverse reactions are identified, reported, and managed

12. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Evaluation (cont’d) Patient complies with prescribed drug regimen Patient and family demonstrate understanding of drug regimen Patient verbalizes importance of complying with prescribed therapeutic regimen

13. Copyright © 2008 Lippincott Williams & Wilkins. End of Presentation