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.