What are they? • Drugs that elevate mood, increase motor activity, increase alertness, and decrease the need for sleep.

• Examples include Ritalin, Adderall, Cocaine and hallucinogens (cannabis)

What are the effects on the body systems? • Produce CNS and respiratory stimulation • Pupil dilation • Increased motor activity • Increased mental alertness • Diminished sense of fatigue. • In children with ADHD these agents decrease restlessness and increase attention span.

What is the therapeutic action?
• The CNS is stimulated by blocking the reuptake of norepinephrine and dopamine into the presynaptic neuron and increasing the release of these monoamines into the extra neuronal space.

What are the therapeutic uses?
• Treatment and management of attention deficit hyperactivity disorder (ADHD), characterized by hyperactivity, poor behavior control and decreased attention span. • Symptoms: – disturbed sleep – distractibility – inability to follow directions properly – decreased memory recall – excessive talking/interrupting, impulsiveness

What are the therapeutic uses?
• Treatment of narcolepsy, a sleep disorder that causes excessive sleepiness and frequent daytime attacks of sleep.

• Appetite suppression

What are the side effects/adverse reactions?
CNS: hyperactivity, insomnia, restlessness, tremor, behavioral disturbances, dizziness, hallucinations, headache, irritability, mania, thought disorder. EENT: blurred vision. CV: SUDDEN DEATH, hypertension, palpitations, tachycardia, hypotension. GI: anorexia, constipation, cramps, diarrhea, dry mouth, metallic taste, nausea, vomiting. Derm: erythema, rashes. Metabolic: growth suppression, weight loss (may occur with prolonged use).

Neuro: akathisia, dyskinesia, tics.
Other: fever, hypersensitivity reactions, physical dependence, psychological dependence, tolerance.

What are the interactions?
• Additive sympathomimetic (↑adrenergic effects) • Use with MAO inhibitors can result in hypertensive crises • Alkalinizing the urine ↓ excretion and ↑effects of amphetamines • Acidification of the urine ↓ effect of amphetamines. • Phenothiazine may also ↓ effects • Methylphenidate may ↓ the metabolism and ↑ effects of other drugs such as warfarin, anticonvulsants, and tricyclic antidepressants

Nursing Considerations
What are some of the nursing diagnosis?

• •

Disturbed thought process, related to disease process and medication Deficient knowledge, related to disease process and medication regimen

What are some nursing implementations? • Instruct patient not to alter dose without consulting health care professional. Abrupt cessation with high doses may cause extreme fatigue and mental depression. Advise patient to avoid intake of large amounts of caffeine.

Caution patient to avoid driving or other activities requiring judgment until response to medication is known. Medication may impair judgment.
Inform patient that periodic holidays from the drug may be used to assess progress and decrease dependence. These medications have high dependence and abuse potential

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