1. Class 2CNS Stimulants

2. Ch. 20-Benzodiazepines/Anxiolytics Oxazepam triazolam

3. Barbiturates Greater Sedation Great Dependence

4. Chapter 20: AnxiolyticsHypnotics

5. SE of Hypnotics, Anxiolytics, Sleep AidsSedation

6. Drowsiness

8. Lethargy

9. Blurred Vision

10. Confusion

11. Dry Mouth

12. Constipation

13. Nausea/Vomiting

14. Hypotension

15. Urinary Retention

16. Antidepressants: Signs of Depression

17. Sleep disturbances

18. Lack of appetite

19. Limited Libido

20. Feelings of Sadness

21. Inability to perform daily activities

22. Tricyclic Antidepressants-TCAs

23. Prototype: Imipramine

24. Monoamine Oxidase inhibitors

25. MAOI Interactions

26. Selective Serotonin Reuptake Inhibitors

27. Serotonin Syndrome

28. Other Antidepressants

29. Ch. 22: Psychotherapeutic DrugsAntipsychotics/Neuroleptics: Used to Treat Schizophrenia Narcolepsy/ADD Mania/BiPolar disorder

30. Typical Antipsychotics

31. Atypical Antipsychotics

32. Antipsychotics & Adolescents

33. Antipsychotics and Dementia

34. Antipsychotic SE Akathisia Tongue thrusting Facial grimacing Jerking of head Mouth puckering Finger movement Blinking Rolling the tongue around the mouth Twitching hands Tapping feet Twisting the trunk

35. Anti-Mania Drugs Lithium Therapeutic Level: 0.6-1.2 mEq/L

36. CNS Stimulants

37. Anti-Seizure Drugs Hydantoins

38. Confusing Drug Names?? Celebrex Cerebyx Celexa

39. Dilantin-Phenytoin Serious Skin Reactions: Side/Adverse Effects Gingival hyperplasia Liver toxicity CNS depression

40. Other Drugs for Seizures:Benzodiazepams: Klonopin & Valium

41. Central Nervous System

42. Use of CNS Stimulants ADHD Narcolepsy Cluster Headaches/Migraines

43. Anorexiants: Obesity NO MORE Phenylpropanolamine

44. Xanthines Purpose: stimulate respiration in newborns Side effects: restlessness, tremors, twitching, palpitations, insomnia Xanthines (methylxantine) Caffeine used in newborns with respiratory distress to stimulate respirations Theophylline

45. Caffeine Increased alertness; Diuretic, cardiovascular stimulation, bronchodilation, increased GI secretion, skeletal muscle stimulation Large amts can cause excessive CNS stimulation: Anxiety, agitation, diarrhea, insomnia, irritable, nervous, PVCs, Toxicity: Delirium, seizures Withdrawal: Headache, fatigue, muscle pain

46. Item Item Size Caffeine Content (mg) Coffee 150 ml (5 oz) 60-150 Coffee, decaf 150 ml (5 oz) 2-5 Tea 150 ml (5 oz) 40-80 Hot Cocoa 150 ml (5 oz) 1-8 Chocolate Milk 225 ml 2-7 Jolt Cola 12 oz 71 Josta 12 oz 58 Mountain Dew 12 oz 55 Surge 12 oz 51 Tab 12 oz 47 Diet Coca Cola 12 oz 45 Coca Cola 12 oz 45

47. Copyright 2003, Elsevier Science (USA). All Rights Reserved. Coca Cola 12 oz 45 Tab 12 oz 46 RC Cola 12 oz 43 Dr. Pepper 12 oz 41 Mr. Pibb 12 oz 40 Pepsi Cola 12 oz 37 Cherry Coca-Cola 8 oz 31 7-Up 12 oz 0 Mug Root Beer 12 oz 0 Sprite 12 oz 0

48. Copyright 2003, Elsevier Science (USA). All Rights Reserved. This is No BULL! Red Bull contains approx 80 mg caffeine in one can (similar to a cup of regular coffee) Caffeine is FATAL in doses of 10 grams

49. And What about Starbucks? (amounts vary by web site) Coffee, tall (12 oz.) 240 mg Coffee, venti (20 oz.) 480 mg Coffee, short (8 oz.) 180 mg Coffee, grande (16 oz.) 320 mg

50. Copyright 2003, Elsevier Science (USA). All Rights Reserved. OTC Drugs with Caffeine Dextrim 200 Vivarin 200 No Doz 100 Excedrin 65 Vanquish 33 Anacin 32 Midol 32 Triaminicin 30 Dristan 16

51. Copyright 2003, Elsevier Science (USA). All Rights Reserved. Caffeine in Common Products Caffeine IS addictive 3-4 cups of coffee is maximum recommended/day Listed as GRAS (Generally Recognized as Safe!) Should be avoided by pregnant women, people with CAD, HTN

52. Respiratory CNS Stimulant Purposes: respiratory depression from drug overdose, postanesthetic respiratory depression, occasionally COPD Doxapram (Dopram)

53. Herbal Stimulants Guarana High in caffeine Found in weight loss products and energy drinks Ma Huang

54. Peripheral Nervous System

55. Autonomic Nervous System

56. Sympathetic Nervous System:Fight or Flight

57. STRESS!!!!

58. Parasympathetic Nervous System: controls Pee, Poop, Puke

59. Adrenergic Drugs

60. Alpha Adrenergic Blocking Agents

61. Alpha Adrenergic Blocking Agents Examples of alpha blockers include: Alfuzosin (Uroxatral) Doxazosin (Cardura) Prazosin (Minipress) Terazosin (Hytrin) Tamsulosin (Flomax)

62. Alpha Adrenergic Blocking Agents

63. Alpha Adrenergic Blocking Agents

64. Beta Adrenergic Blocking Agents

65. Beta Adrenergic Blocking Agents Assess BP, Heart Rate

66. Effects of Beta Blockers: Pupil construction Tears Saliva Slow Heart Rate Bronchoconstriction Increased GI motility Urinary Frequency

67. Cholinergic Drugs

68. Myasthenia Gravis Tensilon Test (edrophonium)

69. Cholinergics Organophosphates used as incecticides Sarin Gas-Bioterrorism Antidote

70. Drugs for Alzheimer’s Disease Cholinesterase Inhibitors: Razadyne® (galantamine) Exelon® (rivastigmine) Aricept® (donepezil). Nursing Care?? Namenda® (memantine)

71. Cholinergic Blocking AgentsAKA Anticholinergics

72. Anticholinergic Effects RED AS A BEET

73. Anticholinergic Effects DRY AS A BONE

74. Anticholinergic Effects MAD AS A HATTER