Pharmacology

Name the medically approved uses for CNS stimulants.

What schedule are Amphetamines?

High potential for abuse. Strong physical and psychologic dependency.

-Increase wakefulness in narcolepsy
-Decrease hyperactivity & impusiveness of ADHD

-Sleeplessness, restlessness, tremors, irritability, anorexia, impotence
-Cardiovascular problems: tachycardia, palpitations, cardiac dysrhythmias, hypertension

Name examples of prescription Amphetamines.

Name examples of prescription of Amphetamine-like drugs for ADHD.

-Drug contraindicated in history of heart disease, hypertension, hyperthyroidism, parkinsonism, or glaucoma.
-Baseline vital signs for comparison
-Assess mental status
-Evaluate growth in children
-CBC,WBC with differential, platelets before and during therapy

-Take before meals
-Avoid alcohol
-Sugarless gum for dry mouth
-Weight 2x/week. Report weight loss
-If tremors or nervousness avoid driving
-Don't stop abruptly, taper.
-Too much caffeine, fatal.
-Notify school nurse of therapy
-Counseling is necessary part of treatment, not just drug therapy.

Modafinil (Provigil) is prescribed for ___?

suppress appetite in obesity

Anorexiants is what class of drugs?

What is the parameter for the time that anorexiants should be used?

Amphetamines are not recommended due to ____?

____ removed from market due to 16X risk of ___ in women.

Children under ___ should not use anorexiants.

Reliance on appetite supressants should be encouraged. T/F

What should be encouraged in the place of using anorexiants?

stimulate respiration in newborns with apneic episdoes

Restlessness, tremors, twitching, palpitations, & insomnia

Caffeine should be administered ____?

Over ___ mg caffeine/day affects the ___ and the ___, may cuase ___.

Name the uses for Respiratory CNS stimulant.
Name an example of a medication.

What color is Doxapram (Dopram)-IV?

What color is Labetalol?

___ is more effective in respiratory depression from some drugs.

Name the classifications of CNS depressants.

Name the types and stages of sleep.

How long are the sleep cycles?

Name a few factors in sleep in children.

How does sleep change in elders?

Name the percentage for incidence of insomnia for every group.
healthy adults
hospitalized patients
psychiatric clients

-Regular wake-up time in morning
-Take a warm bath, read, listen to music
-Drink warm milk before bed
-No naps
-Avoid caffeine 6 hours before bed
-Avoid heavy meals & exercise before bed
-Decrease loud noises
-Avoid drinking large amounts of fluid before bed

decrease responsiveness without change in consciousness unless in larger doses

sleep producing

___ is spent a year on OTC sleep aids

-Residual drowsiness (hangover)
-REM rebound
-Dependence
-Tolerance
-Depression
-Respiratory depression
-Hypersensitivity

suffix is barbital

What class are Barbiturates

Name medication examples of short-actingb barbiturates

Name medication examples of short-acting barbiturates.

-Obtain drug, OTC, & herbal history
-Assess renal function
-Continuous use may lead to drug dependency or abuse
-raise bed rails on hospitalized patients
-observe respiratory rate & signs of observation

How would you assess renal function?

-Try nonpharmacologic sleep methods first
-Avoid alcohol, antidepressant, antipsychotic, and narcotic drugs while taking barbiturates. Risk for respiratory arrest.
-No driving or machinery operation.
-Take 30 mins before bed
-report feeling of hangover or rash
-gradual withdraw to avoid tremors or muscle twitching

Name a medication example of Nonbenzodiazepines.

-less than 10 day treatment of insomnia
-decrease dose in elderly

-new product
-30 mins to fall asleep
-no change in sleep time total or decrease in # of awakenings

-old medication 1860s
-doesn't suppress REM sleep
-less hangover, respiratory depression, and tolerance
-effective in elderly
-gastric irritation common. give with sufficient water
-available in liquid, capsules, suppositories
-brown-yellow syrup

general and local

nitrous oxide

ether and chloroform

1770's Jospeh Priestly

-hypnotic the night before
-premedication with narcotic analgesic or benzodiazepine and an anticholinergic
-short-acting barbiturate & strong analgesic
-inhaled gas
-muscle relaxant

-anesthesia history & reaction
-renal or liver problems
-age
-pregnancy
-heavy smoking obesity, alcohol and/or drug use
-herbals

induce & sustain sleep

minor tranquilizers & anxiolytics

What schedule are benzodiazepines?

selected benzodiazepines are hypnotics

-memory lkoss with prolonged use
-off market in UK

Benzodiazepine Antidote

-Baseline VS and LFTs (AST,
ALT, bilirubin)
-make sure patient is not taking other sedatives or hypnotics
-raise bed rails
-assess for confusion, hangover, dizziness especially in elderly
-fall precautions