Chapter 29 Central Nervous System Stimulants Used to Treat Attention Deficit Hyperactivity Disorder and Agents Used to Treat Alzheimer’s Disease
Jan 18, 2018
Chapter 29
Central Nervous System Stimulants Used to Treat Attention Deficit Hyperactivity Disorder and Agents Used to Treat Alzheimer’s
Disease
Analeptics and Anorexiants p665• Analeptics (CNS
stimulants)• Anorexiants (appetite
suppressants)Anorexiants fall into the category of analeptics. They are CNS stimulants that depress appetite
•
Analeptics p665• Used to treat:
– Attention deficit hyperactivity disorder (ADHD)
– Narcolepsy– Obesity
• Anorexiants • Must be
accompanied by diet plan for weight loss to be permanent
Central Nervous System Stimulants (analeptics) p668
• Cause CNS and cardiovascular stimulation – Restlessness– Insomnia – Anxiety– Palpitations– Tachycardia– Arrhythmias– Hypertension
• Prolonged use produces psychological dependence and tolerance
Attention Deficit Hyperactivity Disorder (ADHD) p665
• Characteristics:– Inattention– Hyperactivity– Impulsivity
• Identified in children and adults
ADHD Treatment agents(analeptics) p666
• Methylphenidate HCl (Ritalin)– Produces paradoxical effect
• Calming effect• Improved attention span (ability to
focus)– May cause psychological dependence– May increase seizures in epileptics
• Pemoline (Cylert)– Produces a paradoxical effect
• Amphetamine mixture (Adderal)– Produces a paradoxical effect
Analeptics for ADHD side effects p666
• GI distress• Insomnia• Headache• Growth suppression in children
–
Atomoxetine HCl (Strattera) p666• Not a CNS stimulant• Increases availability of
norepinephrine– Improves the thought
process– Increases the attention
span• Side effects in adults: dry
mouth, insomnia, dizziness, nausea, constipation
• Side effects in children: N&V, abdominal pain, fatigue, dyspepsia
.
Alzheimer’s disease p665• Loss of cognitive function and
memory • It is a progressive, degenerative,
terminal disease of brain tissue characterized by up to 75% loss of acetylcholine
• Leading cause of dementia• Meds only slow progress of
disease• Temporary effect; effective for
approximately 2 years
Treatment for Alzheimer’s Disease p668
• Donepezil (Aricept) Rivastigmine (Exelon)– Improves the
availability of acetylcholine
– Improves memory– Adverse/side effects
• Mild GI symptoms– Nausea,
vomiting, and diarrhea
• Agitation during initial few weeks
Treatment for Alzheimer’s Disease p670
• Memantine (Namenda)– Action: increases levels of glutamate, a chemical
messenger involved in processing, storing, and retrieving information in the brain
– Side effects• Headache• Dizziness• Confusion• Constipation
Alzheimer’s disease cont p671• 70% Alzheimer’s pt live at home and are
– cared for by family members
• Depression in 20% of Alzheimer’s patients• Depression in as many as 50% of Alzheimer’s care
givers• Antidepressant meds may be appropriate for
patients and their caregivers.