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. |
