CNS stimulants

1. CNS STIMULANTS
ROLL
LAXMI THAPA
ROLL NO: 29
B.SC NURSING
3RD YEAR

2. CONTENTS
 Definition
 Medical uses
 Therapeutic indication & contra indication
 Types
 Dangers of CNS stimulants addiction

4. DEFINITION
CNS stimulants are the psychoactive
drugs that induce temporary
improvement in either mental or
physical function or both

5. MEDICAL USES
ADHD
Narcolepsy
Neonatal apnea
Chronic lethargy
Postural orthostatic tachycardia syndrome
Prolonged depression
Morbid obesity

6. THERAPEUTIC INDICATION
1) Obesity
2) ADHD
3) Narcolepsy

7. THERAPEUTIC CONTRAINDICATION
1. Patient with anorexia
2. Insomnia
3. Asthenia
4. Psychopathic personality
5. H/O homicidal or suicidal
tendencies

8. TYPES
There are two types of CNS stimulants:
A. Psychomotor stimulants
B. Hallucinogens or Psychomimetic
drugs

9. PSYCHOMOTOR STIMULANTS
The stimulants that cause excitement and
euphoria and decrease feeling of fatigue
and increase motor activity.

10. 1. Methylxanthines
-> Xanthine is a purine base
found in most human body
Tissues and fluids and in
Other organism and it is also
Bronchodilators.

12. ADVERSE EFFECT
Moderate dose: insomnia, anxiety,
agitation
High dose: emesis, convulsion
Lethal dose (10gm of caffeine):
cardiac arrhythmia
Suddently stop: lethargy, irritability,
headache

13. 2. Nicotine
A active ingredient in tobacco.
Used in smoking cessation therapy
Nicotine remains imp because:
 It is 2nd only to caffeine as most widely used
CNS stimulants
 it is 2nd only to alcohol as most abused drug

14. Action of Nicotine
LOW DOSE: ganglionic
depolarization
HIGH DOSE: ganglionic blockade

15. ADVERSE EFFECT
I. CNS irritability and tremors
II. Intestinal cramps, diarrhoea
III. Increased HR & BP

16. 3. VARENICLINE
Partial agonist at nicotinic receptor in cns
It produces less euphoric effects than
those produced by nicotine itself

17. SIDE EFFECTS
o Nausea
o Change in taste
o Vomiting
o Abdominal pain
o Constipation
o Serious S/E including suicidal behaviour and
depression

18. 4.COCAINE
Strong stimulant mostly used as recreational
drug.
Commonly snorted, inhaled or injected into
veins.
It is addictive & after short period of use,
there is a high risk that
dependence will occur.

21. ADVERSE EFFECTS
 Anxiety rxn that includes; HTN, tachycardia,
sweating & paranoia
 Depression
 Addicts withdrawing exhibit physical
&emotional depression as well as agitation
 vasoconstriction

22. 5. AMPHETAMINE
• It is a potent CNS stimulants that is used
in tx of ADHD, narcolepsy and obesity
• DEXTROAMPHETAMINE is major member
of this compound
• It is non catecholamine

24. ADVERSE EFFECT
I. Insomnia
II. Irritability
III. Weakness
IV. Dizziness
V. Tremor
VI. Confusion
VII.Suicidal tendencies

25. 6. ATOMOXETINE
• It is a nor epinephrine reuptake inhibitor
approved for the treatment of ADHD
• It is a NE reuptake inhibitor

26. ADVERSE EFFECT
Nausea
Xerostoma(dry mouth)
Appetite loss
Insomnia
Irritability
Hypertension
Hostility

27. 7.METHYLPHENIDATE
• It is a CNS stimulants of phenethylamine and
piperidine classes that is used in tx of ADHD
and narcolepsy
• Less potential for abuse than cocaine
• Properties similar to amphetamine and may
also lead to abuse

28. ADVERSE REACTION
Abdominal pain
Nausea
Anorexia
Insomnia
Nervousness
fever

29. 8.PICROTOXIN
• Also called cocculin is a poisonous crystalline
plant compound
• Acts as a non competitive channel blocker for
GABA receptor chloride channels
• It have stimulant &
Convulsant effect

30. HALLUCINOGENS
• Also called psychotomimetic
• it is the stimulants that produce profound
changes in thought patterns & moods, with
little effect on brain stem & spinal cord
• Incapable of normal decision making because
drug interfere with rational thought

31. A. Lysergic acid diethylamide
• It is a psychedelic drug of ergoline family well
known for its psychological effects which can
include altered thinking processes,
synesthesia, an altered sense of time &
spiritual experiences
• It is non addictive

32. USES
Treatment of alcoholism
Pain & cluster headache relief
End-of-life anxiety for
Spiritual purpose & to enhance
creativity

33. ADVERSE EFFECT
Hyperreflexia
Nausea
Muscular weakness
High dose may produce long lasting psychotic
changes in susceptible individuals

34. B. Tetrahydrocannabinol (THC)
• The main psychoactive alkaloid contained in
marijuana is THC which is available as
DRONABINOL
• THC can produce euphoria followed by
drowsiness & relaxation

36. ADVERSE EFFECT
o Increased HR
o Decreased BP
o Reddening of conjunctiva
o At high dose, toxic psychosis
develops

37. C. RIMONABANT
• It is an anorectic antiobesity drug that use to
treat obesity
• It induces psychiatric disturbances, such as
anxiety and depression
• Indicated with a BMI >30 kg/m2
or pt. with BMI >27 kg/m2
associated with risk factors like DM
dyslipidaemia

38. POTENTIAL USES
i. Obesity
ii. Smoking cessation
iii. Addiction behaviour
iv. Short term memory
v. Blockage of cannabis effect

39. D. PHENCYCLIDINE
• Also known as PCP or “ANGEL DUST”
• Inhibits reuptake of dopamine
• Major action is to block ion channel regulated
by NMDA subtype of glutamine receptor

40. CNS stimulant Addiction
Increased intolerance
Withdrawal symptoms
Severe depression & suicidal thoughts
Damage to body organ including heart &
respiratory system
Illness due to poor nutrition
Work & family problems
impotence

41. QUESTION
The nurse would expect the physician to order
which drug for the treatment of ADHD in
children?
A. Zolmitriptan (zomig)
B. Doxapram HCL (dopran)
C. Benzphetamine HCL (didrex)
D. Methylphenidate HCL (ritalin)

42. ANSWER
• METHYLPHENIDATE is most commonly used to
treat ADHD
• ZOLMITRIPTAN is used to treat migraines
• DOXAPRAM is used as a respiratory stimulant
• BENZPHETAMINE is an anorexiant

43. ANY QUESTION?????????