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exam 3 pharm

ch 20

CNS stimulates ☺are used to treat ADHD, narcolepsy, reversal of resp distress ☻includes amphetamines and caffeine to stimulate the cerebral cortex ♥analeptics and caffeine to stimulate respiration ♦anorexiants - diethylpropion - suppress appetite by stimulating satiety center in hypothalamic and limbic areas ♣amphetatimes are related to anorexiants and are abused
migraine HA ☺thought to be caused by changes in the brainstem which activates the trigeminal nerve, low serotonin levels may trigger the trigeminal system to release neuropeptides which causes pain ☺triggers: beer, red wine, aged cheese, chocolate, caffeine, MSG, skipping meals, intense exercise, female hormone changes, bright lights, BC, vasodilators
cluster HA ☺same cause as migraine ☻recur 1-3/day ina period lasting from 2 weeks to 3 months ♥do not usually have triggers but etoh, nicotine and nitro may lead to severe HA
ADHD ☺dysregulation of serotonin, norepi, dopamine ☻more common in boys ♥child may display poor coordination and there may be abnormal EEG findings ♦intelligence is not affected but may have learning disabilities
amphetamines ☺stimulate the release of norepi and dopamine ☻cause euphoria and alertness; also cause sleeplessness, restlessness, tremors, irritability, ↑HR, palpitations, dysrhythmias, ↑BP ♥half-life 4-30 hrs ♦used for narcolepsy and ADHD ♣include: amphetamine (Adderall), dextroamphetamine (Dexedrine), methamphetamine (Desoxyn)
s/e of amphetamines restlessness, insomnia, tachycardia, HTN, palpitations, dry mouth, anorexia, wt loss, diarrhea, constipation, impotence
methylphenidate (Ritalin) ☺ADHD and narcolepsy ☻CI: hyperthyroidism, anxiety, seizures, CAD, HTN, Tourette's, glaucoma, psychosis, mental depression, parkinsonism ♥caution: not to be used by children <6 yo, substance abuse, pregnancy s/e: anorexia, vomiting, diarrhea, insomnia, dizziness, nervousness, euphoria, blurred vision, HA, ↑hyperactivity, abd pain, anemia, URI a/e: tachycardia, HTN, growth suppression, palpitations, seizures, wt loss, exfoliative dermatitis, stroke, thrombocytopenia, hepatoxicity
NC Ritalin ☺may reverse the effects of antiHTNs ☻evaluate height, weight, and growth in children ♥report s/e ♦teach: take before meals, avoid etoh, use sugarless gum for dry mouth, do not abruptly d/c - can cause withdrawal, read OTCs for caffeine content - high levels of caffeine could be fatal, no BF, get counseling, eat a good breakfast,
anorexiants ☺amphetamines are no longer used for appetite control ☻↑risk of hemorrhagic stroke in women but not in men ♥may cause renal failure, psychosis, HTN, dysrhythmias
lipase inhibitors ☺replaced anorexiants for wt loss ☻s/e: oily spotting, fecal urgency and incontinence, steatorrhea, flatus with discharge, HA, n/v, abd cramps, hypoglycemia
analeptics ☺CNS stimulant ☻use: stimulate respiration ♥xanthines - caffeine and theophylline ♦newborns may be given caffeine to ↑resp ♣theophylline is used to relax the bronchioles and ↑resp in newborn
s/e of caffeine ☺same as for anorexiants plus GI irritation, tinnitus, psychological dependence ☻half-life is approx 5 hrs, this is prolonged in pts with liver disease, those taking BC or pregnant ♥no caffeine while pregnant b/c effect on fetus is unk
resp stimulants ☺doxapram (Dopram) ☻used to treat resp depression due to OD, postanesthetic resp depression, COPD ♥can ↑BP ♣IV - onset 20-40 seconds with peak in 2 minutes ♠s/e: HTN, tachycardia, tremors, spasticity and hyperactive reflexes •mechanical ventilation is more effective for treating resp depression
Created by: nursingTSJC2013



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