CNS Stimulants

CNS Stimulants
 Potentiate the excitatory neurotransmissors such as dopamine,
norepinephrine, and serotonin.
 Mimic the actions of the Sympathetic Nervous System:
 Stimulate CNS and respiratory systems,
 Mood elevation (euphoria),
 Increase mental alertness and capacity to work, decrease fatigue and drowsiness.
Used for the treatment of conditions such as:
 Attention Deficit Hyperactivity Disorder (ADHD)
 Narcolepsy (sleep attack)
 Obesity
 Migraines
 Neonatal apnea
 Question
Which statement correctly identifies the pharmacodynamics of
CNS stimulants?

CNS stimulants decrease the production of excitatory

neurotransmitters.
CNS stimulants increase release of and block reuptake of
neurotransmitters.
CNS stimulants block the activity of inhibitory neurons.
CNS stimulants enhance the effects of phosphodiesterase and
subsequent breakdown of cyclic adenosine monophosphate
(cAMP).
 Answer
Which statement correctly identifies the pharmacodynamics of
CNS stimulants?

CNS stimulants decrease the production of excitatory

neurotransmitters.
CNS stimulants increase release of and block reuptake of
neurotransmitters. Correct
CNS stimulants block the activity of inhibitory neurons.
CNS stimulants enhance the effects of phosphodiesterase and
subsequent breakdown of cyclic adenosine monophosphate
(cAMP).

CNS stimulation occurs when the amount of neurotransmitters

being released and the duration of action of excitatory
neurotransmitters are increased.
 CNS Stimulants
Caffeine: a CNS stimulant that can be found in many beverages, foods,
and OTC drugs
Family of methyl-xanthines such as theophylline.
Methylphenidate (Ritalin)
Amphetamine mixture: (Adderall)
Dextroamphetamine: (Dexedrine)
Atomoxetine (Strattera)
Non-stimulant, not controlled substance
Modafinil
 Non-stimulant drug for Narcolepsy.
 Side/Adverse Effects
 CNS stimulation (insomnia, restlessness, elevate mood, increase energy and
alertness)
 Weight loss because increase metabolic rate
 Cardiovascular effects :
 Dysrhythmias and sudden death
 Angina
 Hypertension
 Psychotic symptoms such as hallucinations, paranoia
 Withdrawal reaction

Medication/Food Interactions
 Concurrent use of MAOI s may cause hypertensive crisis.
 Concurrent use of caffeine may increase CNS stimulant effects.
 OTC cold and decongestant medications with sympathomimetic action
 Question
The mother of a child with attention deficit hyperactivity disorder
(ADHD) who has been prescribed methylphenidate (Ritalin)
expresses concern regarding the use of a controlled substance to
treat her child and asks if there are any other options. The nurse’s
response is based on the knowledge that an option for treatment
for ADHD might include which non-controlled central nervous
system (CNS) stimulant?

atomoxetine (Strattera)
dextroamphetamine sulfate (Dexedrine)
methylphenidate (Concerta)
amphetamine aspartate (Adderall)
 Answer
The mother of a child with attention deficit hyperactivity disorder
(ADHD) who has been prescribed methylphenidate (Ritalin)
expresses concern regarding the use of a controlled substance to
treat her child and asks if there are any other options. The nurse’s
response is based on the knowledge that an option for treatment
for ADHD might include which non-controlled central nervous
system (CNS) stimulant?
atomoxetine (Strattera) Correct
dextroamphetamine sulfate (Dexedrine)
methylphenidate (Concerta)
amphetamine aspartate (Adderall)

Atomoxetine (Strattera) is not a controlled substance as it lacks

addictive properties, unlike amphetamines and phenidates.
 Migraine Medications
Therapeutic Uses
Stopping an acute migraine attacks
Prevention of migraine attacks
Select Prototype Medications:
Serotonin receptor agonists (Triptans): sumatriptan
 Agonist of serotonin receptors in the brain
 More effective during aura
 Vasoconstriction: chest pain, angina
Ergot alkaloids: ergotamine
 Vasoconstriction
 Combination with caffeine enhance absorption and action
 Ergotism: fingers numbness and paleness: discontinue
 Abortive
 Abuse
 Question
Ergot alkaloids such as ergotamine tartrate (Ergostat) exert a
therapeutic effect by causing:

vasoconstriction.
vasodilation.
blockade of the beta2 receptors.
simulation of the alpha receptors.
 Answer
Ergot alkaloids such as ergotamine tartrate (Ergostat) exert a
therapeutic effect by causing:

vasoconstriction. Correct
vasodilation.
blockade of the beta2 receptors.
simulation of the alpha receptors.

Ergot alkaloids block alpha2 receptors, causing vasoconstriction.

They are useful in treating vascular headaches caused by
vasodilation of vessels in the brain.
 Anorexiants
CNS Stimulants:
 Methamphetamine: anorexia and increased metabolic rate

Other Drugs:
 Orlistat works by inhibiting fat absorption in the GI tract.

Side/Adverse Effects
 Increase BP, palpitations, and dysrhythmias at higher doses.
 Anxiety, agitation, dizziness.
 Orlistat: GI distress and oily stools. Blocks absorption of fat-soluble
vitamins (A, D, E, K).