1. Chapter 29 Central Nervous System Stimulants Used to Treat Attention Deficit Hyperactivity Disorder and Agents Used to Treat Alzheimer’s Disease

2. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 2 Analeptics and Anorexiants Analeptics  Common central nervous system stimulant  Caffeine Anorexiants  Contain amphetamines  Depress the appetite

3. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 3 Anorectic Agents Some used to treat:  Attention deficit hyperactivity disorder (ADHD)  Narcolepsy

4. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 4 Central Nervous System Stimulants Cause CNS and cardiovascular stimulation  Restlessness  Sleeplessness  Anxiety  Palpitations  Tachycardia  Arrhythmias  Hypertension (continues)

5. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 5 Central Nervous System Stimulants Prolonged use produces psychological dependence and tolerance (continued)

6. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 6 ADHD Treatments Methylphenidate HCl (Ritalin) Pemoline (Cylert)  Both amphetamine derivatives  Produce a paradoxical effect  Calming effect  Improved attention span  Adverse effects  GI distress, insomnia, headache, and depression  Growth suppression

7. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 7 Atomoxetine HCl (Strattera) Not a CNS stimulant Increases availability of norepinephrine  Improves the thought process  Increases the attention span

8. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 8 Treatment for Alzheimer’s Disease Alzheimer’s disease seriously affects memory  Acetylcholine is notably absent Examples of drug agents  Stops the action of cholinesterase inhibitor  Donepezil HCl (Aricept)  Rivastigmine tartrate (Exelon) (continues)

9. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 9 Treatment for Alzheimer’s Disease Improves the availability of acetylcholine Improves memory Adverse/side effects  Mild GI symptoms  Nausea, vomiting, and diarrhea  Agitation during initial few weeks (continued)

10. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 29 - 10 Nursing Implications Monitor for therapeutic effects. Evaluate for effectiveness.