Learning Center Articles

Precautions C N S stimulants

Precautions

C N S stimulants

  • Use caution in children with psychoses; clients with Tourette’s disorder, anorexia, or insomnia; elderly, debilitated, or asthenic clients; and clients with a history of suicidal or homicidal tendencies; prolonged use may result in tolerance and physical or psychological dependence.

Dexmethylphenidate and methylphenidate

  • Effects of concomitant use
  • Hypertensive crisis may occur with coadministration of M A O I’s

Atomoxetine and bupropion

  • Use caution in clients with urinary retention; hepatic, renal, or cardiovascular disease; suicidal clients; pregnancy; and elderly and debilitated clients.

Alpha agonists

  • Use caution in clients with coronary insufficiency, recent M I, or cerebrovascular disease; in chronic renal or hepatic failure; the elderly; and in pregnant clients and those lactating.

Nursing diagnosis

  • Risk for injury
  • Risk for suicide
  • Imbalanced nutrition
  • Insomnia
  • Nausea related to side effects of atomoxetine or bupropion
  • Pain related to side effects of abdominal pain with atomoxetine or bupropion or headache
  • Risk for activity intolerance

Planning/Implementation

  • Monitor client for the following side effects:
  • Overstimulation, restlessness, insomnia, palpitations, tachycardia, anorexia, weight loss, tolerance, physical and psychological dependence, nausea and vomiting, constipation, dry mouth, sedation or rebound syndrome, potential for seizures, liver damage, and new or worsened psychiatric symptoms

Drug Classification

Drug trade/ Generic names

Actions

Side effects

Nursing implication

ADHD

Ritalin (Methylphenidate)

Adderall(Amphetimine)

Stratt/’era (Atomoxatine).

Direct and indirect agonists to adrenergic receptor sites, mimicking the effects of norepinephrine or dopamine resulting in a calming effect.

Agitation, exacerbation of psychotic thought processes, hypertension, and long term growth suppression.  Potential for abuse. With Strattera, decreased appetite, weight loss, fatigue, and dizziness.

Monitor levels of activity, periodic vital signs.  Monitor growth activity.