Presented By Mr. Pradeepsingh N B Asst.Professor HOD of Medical-Surgical Nursing

1. Presented By
Mr. Pradeepsingh N B
Asst.Professor
HOD OF Medical –Surgical Nursing

2. INTRODUCTION
 Neuropharmacalogy is the study of how drugs affect cellular function in the
body, the nervous system and neural mechanism through which they influence
behavior.
 Neuropharmacology is a region of science that encompasses many aspects of
nervous system from single neuron manipulation to entire areas of brain,spinal
cord, and peripheral nerves.
 There are two main branches of neuropharmacology:
BEHAVIOURAL
MOLECULAR

3. BEHAVIOURAL
NEUROPHARMACOLGY
 It focuses on the study of how drugs affect human
behavior, including the study of how drug dependence and
addiction affect the human behavior.

4. MOLECULAR NEUROPHARMOLOGY
It involves the study of neurons and their
neurochemical interactions, with the overall goal of
developing drugs that have beneficial effects on
neurological function.

5. CENTRAL NERVOUS SYSTEM AGENTS

6.  Central nervous system agents are medicines that affect the CNS.
 The CNS is responsible for processing and controlling most of our bodily functions and consist
of nerves in brain & spinal cord.
 The drugs that work on CNS include:
Analgesics and anti pyretics
Anesthetics
Hypnotics and sedatives
Cholinergic drugs
Anticholinergic drugs
Muscle relaxants
Antipsychotic drugs

7. Antidepressants
Anticonvulsants
Adrenergic drugs
Mood stabilizing agents
Acetylcholine
Antiemetics
Antiparkinson
Central Nervous System stimulants

8. SEDATIVES AND HYPNOTICS

9. SEDATIVE
S
It is a drug that produces calming or quietening effect and
reduces excitement, it may induce drowsiness.
Drugs that calm the patient and reduce anxiety without
inducing normal sleep.

10. HYPNOTICS
It is a drug that induces sleep, resembling natural sleep.
Drugs that initiate and maintain normal sleep.

11. CLASSIFICATION

12. BENZODIAZEPIN
ES

13. PHARMACOLOGICAL
ACTION
 Sedation and hypnosis
 Reduction in anxiety
 Anaesthesia
 Muscle relaxation
 Anticonvulsion effect
 Amnesia
 Other actions such as decrease in nocturnal gastric secretion and
prevents stress ulcers.

14. DOSE/ ROUTE/FREQUENCY
• 0.25mg – 1mg , TID , oral
• Maximum dose – 4mg/day
Alprazolam
• 5mg – 25mg , TID/QID , oral
• Maximum dose – 100mg/day
Chlordiazepoxide
• 0.5mg – 1mg , TID , oral
• Maximum dose – 20mg/day
Clonazepam
• 5mg – 25mg , TID/QID , oral
• Maximum dose – 40mg/day
Diazepam
• 0.5mg – 1mg , TID/QID , oral.
Lorazepam
• 10mg – 30mg , TID/QID , oral
• Maximum dose – 120mg/day
Oxazepam

15. MECHANISM OF ACTION

16. PHARMACOKINETICS
 Benzodiazepines are completely absorbed on oral administration.
 Intramuscular absorption is slow, hence oral route is preferred.
 They are extremely bound to plasma protein metabolized in the liver
& excreted through kidney.

17. ADVERSE
EFFECTS

18. CLASSIFICATION
BARBITURATES
ULTRA SHORT ACTING
(< 15-20min)
-Theopentone
- Melhohexitone
SHORT ACTING
(< 3hours)
-Hexobarbitone
- Pentobarbitone
- Secobarbitone
LONG ACTING
(6-12hours)
- Mephobarbitone
- Phenobarbitone

19. DOSE / ROUTE / FREQUENCY
1. Mephobarbitol : 32mg – 100mg TID/QID oral
2. Pentobarbitol : For trouble sleeping – 100mg OD (night) oral
For sedation before surgery - 100mg before surgery oral
3. Phenobarbitol : Troubled sleeping – 100mg-320mg OD (night) oral
Sedation before surgery – 3.5mg/kg body weight
4. Secobarbitol : 200mg-300mg before surgery, oral
100mg for troubled sleep

20. PHARMACOLOGICAL ACTION
1. CNS: Produce dose dependent effect.
- Hypnotics dose shortens the time taken to fall asleep and increases
duration.
- Sedative dose given at day time can produce drowsiness, reduction in
anxiety and excitability.
- No analgesic effect but can cause hyperalgesia
- Anticonvulsant property.

21. 2. Other systems
- Respiratory: Depressed in higher dose.
- CVS: Slight decrease in BP and heart rate.
- Skeletal muscle: Hypnotic dose has a little effect but anaesthesia
dose reduces muscle contraction by action on neuromuscular
junction.
- Smooth muscle: Tone and motility of bowel is decreased by hypnotic
dose.
- Kidney: Tend to reduce urine flow.

22. PHARMACOKINETICS
 Barbiturates are well absorbed from the GI tract and widely
distributed in the body.
 The rate of entry into CNS depends on the lipid solubility.
 Redistribution from CNS to skeletal muscle.
 Metabolized in the liver by oxidation, dealkylation and conjugation.
 Metabolites are excreted in urine.

23. INDICATIONS
 Except for phenobarbitone in epilepsy and thiopentone in
anesthesia no other barbiturates are used now.
 Used in psychosomatic disorders.
 Hypnotics and anxiolytics.

24. ADVERSE
EFFECTS
HANGOVER DRUG TOLERANCE
HALLUCINATIONS

25. MISCELLANEOUS
1. PARALDEHYDE
- It is a colorless, transparent, pungent, inflammable liquid.
- It is an irritant and can dissolve plastic syringe.
- It also has anticonvulsant properties.
 ROUTE
- Rectal
- Intra muscular
- Oral
 USES
- As a convulsant in status epilepticus particularly in children
- Hypnotic rarely used.

26. 2. MELATONIN
- The hormone secreted by the pineal gland is known to regulate sleep.
- Melatonin acts on the melatonin receptors.
- It doesnot depress the CNS, it improves the quality of sleep and helps in
withdrawing benzodiazepines after long term use.
3. RAMELTEON
- It is an agonist at the melatonin receptors is a novel hypnotic drug.
- It doesnot modify the sleep.
- The duration of action is prolonged.
- Adverse effects are dizziness and fatigue.

27. NURSES
RESPONSIBILITIES
 Nursing considerations for benzodiazepines involve:
- Careful monitoring of the patient’s condition
- Education of the medication regimen
 Benzodiazepines are a schedule IV drug, so the patient should be
assessed for drug abuse potential and dependence.
 These drugs are a pregnancy risk.
 Since benzodiazepines change intraocular pressure, patients with narrow
angle glaucoma should not receive these drugs.
 Liver and kidney function should also be monitored.
 Respiratory depression may result if patient is taking other CNS
depressants.

28.  Common side effects include drowsiness and dizziness.
 If a patient receives an overdose of benzodiazepines should be
administered to reverse the CNS depression.
 All forms of nicotin should be avoided because they decrease the
effectiveness of benzodiazepines.
 Rebound seizures may develop if the drug is abruptly stopped.
 The drug should be taken with food to prevent GI disturbance.
 Do not mix these drugs with others because they tend to precipitate and
irritate the
 Patient teaching should include avoiding alcohol, drugs, herbal
medications without prescription.

29. CHOLINERGIC DRUGS

30. INTRODUCTION
 Cholinergic drugs are drugs that inhibit, enhance or mimic the
action of neurotransmitter acetylcholine, the primary transmitter
of nerve impulses within the parasympathetic nervous system.
 Parasympathetic nervous system is a part of autonomic nervous
system that controls smooth muscles, dilates blood vessels,
increases bodily secretions and slows the heart rate.

31. CHOLINERGIC DRUGS
DIRECT ACTING
- Acetylcholine
- Bethanechol
- Carbachol
- Methacholine
- Pilocarpine
INDIRECT
ACTING
REVERSIBLE
LIPID SOLUBLE
- Physiostigmine
- Tacrine
- Donepzil
- Revastigmine
WATER SOLUBLE
- Neostigmine
- Pyridostigmine
- Endophorium
IRREVERSIBLE
ORGANO-PHOSPHATE
- Melathion
- Parathion
- Chloropyrifos
CARBAMATES
- Carbaryl
- Aldecarb

32. DIRECT ACTING
CHOLINERGICS
 These agents mimic the effect of acetylcholine by binding directly to
the cholinoreceptors.
 They are synthetic esters of choline such as carbachol and
bethanechol or naturally occurring alkaloids such as pilocarpine.
 All these drugs have longer duration than acetylcholine.

33. 1. ACETYLCHOLINE
 It is a neurotransmitter of parasympathetic nervous system and cholinergic nerves.
ACTION
• Decreases heart rate and cardiac output.
• Decreases blood pressure due to vasodilation
OTHER ACTIONS
- GIT: Increases salivary secretion and increases intestinal motility & secretion.
- Respiration: Stimulates bronchiolar secretions.
- Genitourinary tract: Increases detrusor muscle tone.
- Eye: Miosis (marked constriction of pupil)

34. Corneal Swelling
Bradycardia Hypotension
Breathing difficulty Sweating
SIDE EFFECTS OF ACETYLCHOLINE

35. 2. BETHANECHOL
 Structurally related to ACH, has a strong muscarinic activity.
 It directly stimulates muscarinic receptors of GIT causing increase
intestinal motility & tone.
USES
• Bladder stimulation in postpartum & post operative non
obstructive urine retention.

36. Sweating Salivation
Hypotension
Nausea Diarrhoea Bronchospasm Abdominal pain

37. 3. PILOCARPINE
 Mainly used in ophthalmology, it exhibit muscarinic activity, it produces rapid miosis
& contraction of the ciliary muscle.
USES
• It is a drug of choice in the emergency lowering of intra-ocular pressure in case of
glaucoma.
SIDE EFFECTS
- It can enter the brain and cause CNS disturbance.
- It stimulates profuse sweating.
- Salivation

38. INDIRECT ACTING
CHOLINERGIC DRUGS
 These are drugs that exert cholinergic actions by prolonging the life
time of acetylcholine via the inhibition of acetyl-cholinesterase
enzyme.
 This results in accumulation of ACH in synaptic space and provokes
response at all cholinoceptors in the body as well as neuromuscular
junction and the brain.
 These drugs are termed reversible and irreversible.

39. REVERSIBLE
ANTICHOLINERGICS
PHYSOSTIGMINE NEOSTIGMINE PYRIDOSTIGMINE

40. EYE: Glaucoma,
accommodative
esotropia
URINARY TRACT:
Neurogenic bladder
GASTROINTESTINAL
TRACT:
Postoperative atony
NEUROMUSCULAR
JUNCTION:
Myasthenia gravis
THERAPEUTIC USES OF CHOLINOMIMETICS

41.  It is reversible inhibitor of acetylcholinesterase and potentiate
cholinergic activity throughout body.
 It stimulates muscarinic & nicotinic receptors of autonomic nervous
system, its duration of action is 2-4 hours, it can enter & stimulate
CNS.

42. Bladder atony Glaucoma Overdose of
anticholinergic drugs

43. BRADYCARDIA
CONVULSIONS
Skeletal muscle paralysis
due to inhibition of
ACHesterase at NMJ and
ACH accumulation
SIDE EFFECTS OF PHYSOSTIGMINE

44.  Synthetic compound reversibly inhibits acetylcholinesterase, it
doesnot enter the CNS.
 It has greater effect on skeletal muscle that can increase contractibility
then paralysis.
USES
• Stimulates atonic bladder & intestines
• Antidote for neuromuscular blocking agents
• Symptomatic treatment in myasthenia gravis

45. Salivation Hypotension Abdominal pain
Diarrhoea Bronchospasm Nausea
SIDE EFFECTS OF
NEOSTIGMINE

46.  These are synthetic organophosphorus compounds that bind
acetylcholinesterase covalently and inhibit it irreversibly, so there will be
increase in ACH at all sites of its release.
 These drugs are extremely toxic & used in military as nerve agents.
 Some agents like parathion and Malathion are used in insecticides.

47.  These drug causes permanent inactivation of acetylcholinesterase, the restoration of
enzyme activity requires synthesis of new enzymes.
 It causes generalized cholinergic stimulation, paralysis of motor function leading to
breathing difficulties, convulsions.
 The inhibited acetylcholinesterase can be reactivated by pralidoxime which is a synthetic
compound that can regenerate new enzyme.
CLINICAL USES
• Ointment used topically for the treatment of glaucoma, its effect may last for one week
after a single administration.
• Echothiophate has also the same uses of Isoflurophate.

48.  Acute intoxication which must be recognized & treated properly.
 The dominant initial signs are:
- Miosis
- Salivation
- Sweating
- Brochial constriction
- Vomiting
- Diarrhoea
 Cognitive disturbances, convulsions & coma usually follow rapidly.

49. TREATMENT
1. Maintainance of vital signs, Respiration may be impaired.
2. Atropine parenterally in large doses given as often as required to
control signs of muscarinic excess.
3. Therapy often also includes treatment with pralidoxime &
administration of benzodiazepines for seizures.

50.  Administer oral drug on empty stomach to decrease nausea and vomiting
 If drug is given intra venously, administer slowly to avoid severe cholinergic effects.
 Maintain atropine as standby to use it as an antidote for excessive doses of cholinergic
drugs.
 Discontinue drud if excessive salivation, diarrhea, emesis or frequent urination becomes
a problem to decrease the risk of adverse reactions.
 Provide safety precautions of the patients reports poor visual activity in dim light to
prevent injury.
 Provide comfort measures.
 Provide patient education about drug effects and warning signs.

52.  Anticholinergics are drugs that block the action of acetylcholine.
USES
Urinary incontinence Overactive bladder Chronic Obstructive
Pulmonary Disorder
Parkinson’s disease

53. Anticholinergic drugs
Atropine
Cyclopentolate
Dicyclomine
Fesoterodine
Hyoxyamine
Oxyluitynin
Trospium

54. Myasthenia
Gravis
Hyperthyroidism Glaucoma
Enlarged
Prostate
Down
Syndrome
CONTRAINDICATIONS OF ANTICHOLINERGICS

55. SIDE EFFECTS OF ANTICHOLINERGIC DRUGS

56.  Assess the consciousness level of the patient before administering the
drug.
 Monitor for the signs of anticholinergic crisis.
 Provide comfort measures for dryness of mucous membranes.
 Minimise exposure to heat or cold or strenuous exercise.
 Monitor input and output chart.

57.  Monitor patient for abdominal distension and auscultate for bowel
sounds.
 Prevent adverse drug reactions.
 Provide patient and family education.
 Emphasize the importance of adequate fluid and salt intake.

58. MUSCLE RELAXANTS
 These are the drugs that relax muscles.
 These are used to reduce discomfort in acute, painful musculoskeletal disorders
such as muscle spasms.
CLASSIFICATION
MUSCLE RELAXANTS
Centrally acting muscle relaxants
Direct acting muscle relaxants

59.  These drugs act on central nervous system to interfere with the
reflexes that cause muscle spasms.
 These drugs include :
- Baclofen
- Caridoprodol

60. Indications
Trigeminal
neuralgia
Spasuity
Dose
5 mg, TID
Contraindications
Skeletal muscle
spasms due to
cerebral palsy
Parkinson’s
disease
Side effects
Dizziness
Nausea
Vomiting
Headache
Confusion

61. Indications
Relief of discomfort
from acute, painful
musculoskeletal
conditions
Dose
350mg, QID
Side effects
Dizziness
Headache
Nausea & Vomiting
Dyspnea
Tachycardia
Abdominal cramps

62. DIRECT ACTING MUSCLE RELAXANTS
 These drugs affect peripheral muscle contraction.
DANTROBENE
Indications
Cerebral palsy
Multiple sclerosis
Muscular dystrophy
Polio
Tetanus
Dose
25 – 100 mg, QID
Contraindications
Allergy
Hepatic disease
Side effects
Drowsiness
Dizziness
Diarrhoea
Constipation
Insomnia
Headache

63.  Monitor patients response to drug.
 Provide thorough teaching to the patient about drug, its effects and its side effects.
 Explain the patient to avoid alcohol or other depressants while taking medications.
 Evaluate the patient for therapeutic response.
 Explain the patient that drowsiness usually diminishes with continued therapy.
 Instruct the patient to change position slowly which helps to prevent dizziness.
 Discontinue the drug if any signs of hypersensitivity are seen.
 Screen patient for cardiac depression, pregnancy, lactation or epilepsy.

64.  Antipsychotic drugs are used to manage psychosis including
delusions, paranoia and hallucinations.
 They are also known as neuroleptics or major tranquilizers.

65. • 40 – 800 mg/day
Chlorpromazine
• 6 – 30 mg/day
Thiothixene
• 1 – 100 mg/day
Haloperidol
• 300 – 900 mg/day
Clozapine
• 20 – 250 mg/day
Loxapine
• 4 – 8 mg/day
Risperidone

67. MECHANISM OF ACTION

68. Treatment of acute and chronic psychosis.
Selected agents are used as antiemetics.
Treatments of hiccoughs.
Vocal utterances in Tourette’s disorder.

69. CONTRAINDICATIONS
Hypersensitivity CNS depression Parkinson’s
disease
Liver, renal and
cardiac
insufficiency

70. Dry mouth Constipation Delirium Urinary
Retention
Orthostatic
hypotension

71.  Risk for other directed violence related to panic anxiety & mistrust of others.
 Risk for injury related to medication side effects of sedation, extra pyramidal symptoms,
tardive dyskinesia.
 Client is instructed not to abruptly stand to prevent fall due to orthostatic hypotension.
 Check vitals before and after medication.
 Increased intake of fluid& high fibre diet is recommended to avoid dry mouth and
constipation.
 Educate client to wear full sleeves and eye gears while going out to avoid
photosensitivity.

72. ANTI DEPRESSANTS
 Anti depressants are used in the treatment of major depression
with psychotic symptoms, alcoholism, schizophrenia or mental
retardation.
 These drugs elevate mood and alleviate other symptoms
associated with moderate to severe depression.

73. • 50 – 300 mg/day
Amitreptyline
• 25 – 300 mg/day
Doxepin
• 200 – 450 mg/day
Bupropion
• 150 – 500 mg/day
Trazodone
• 20 – 60 mg/day
Citalopram
• 20 – 80 mg/day
Fluoxetine
• 200 – 600 mg/day
Nefazodone
• 45 – 90 mg/day
Phenelzine

74. INDICATIONS OF ANTIDEPRESSANTS
Unipolar or
bipolar
disorder
Generalized
anxiety disorder
Hypochondriasis
Post
traumatic
stress
disorder
Bulimia
Nervosa

75. SIDE EFFECTS OF ANTI DEPRESSANTS
Sedation Dry mouth
Sexual
dysfunction
Insomnia Weight gain

76. CONTRAINDICATIONS OF ANTIDEPRESSANTS
Hypersensitivity
Pheochromocytoma
( tumor on adrenal
gland )
Cardiac arrhythmias Hyperthyroidism

77. NURSE’S RESPONSIBILITIES
 Risk for suicide related to depressive mood.
 Risk for injury related to side effects of sedation, photosensitivity,
arrhythmias, etc.
 Socially isolated related to depressive mood.
 Constipation related to side effects of the medication.

78. ANTICONVULSANTS
 Treatment of convulsions varies with the type of seizures.
 Anticonvulsants inhibit neuromuscular transmission, they may be
used for :
I. Long term management of chronic epilepsy (recurrent seizures)
II. Short term management of acute seizures
III. Emergency treatment of status epilepticus (continuous seizures)

79. Hydantoins
Barbiturates
Benzodiazepines
Succinimides
Sulphonamides
Classification
of
anticonvulsants

80. • 100mg BD
Phenytoin
• 200 – 400 mg TDS
Carbamazepine
• 200 mg TDS
Sodium valproate
• 50 mg/day
Lamotrigine
• 0.5 – 5 mg/day
Clonazepam

81. MECHANISM OF ACTION
 Anticonvulsants suppress the excessive rapid firing of neurons
during seizures.
 Anticonvulsants also prevent the spread of seizure within the
brain.

82. INDICATIONS OF ANTICONVULSANTS
Psychomotor
seizures
Alcohol
withdrawal
syndrome
Cardiac
arrhythmias
Status
epilepticus
seizures
during surgery
Mixed
seizures

83. CONTRAINDICATIONS OF ANTICONVULSANTS
Respiratory
obstructions
Hematologic
disorders
Hepatic
dysfunctions
Complete
heart block
History of
bone
marrow
suppression

84. SIDE EFFECTS OF ANTICONVULSANTS
Nausea
Muscle
and joint
pain
Respiratory
depression
Megaloblastic
anemia
Numbness Alopecia

85. NURSE’S RESPONSIBILITIES
 Excessive use of alcohol should be reduced for the efficacy of the drug.
 Give oral drugs with meal to minimize gastric irritation.
 Prolonged use may led to drug tolerance.
 Advice periodic ophthalmologic examinations, because drug can produce
ocular damage.
 Note that confusion, agitation and behavioral disturbances occurs
commonly in elderly people.
 Use cautiously in patients having hepatic and cardiac diseases and in
elderly and pregnant women.

86. MOOD STABILIZERS
 Mood stabilizers are the drugs used to treat mood disorders,
generally characterized by rapid unstable mood shifts alternating
between mania & depression.
 Mood stabilizers are more effective in mania than the depressive
phase of illness.

87. CLASSIFICATION
Lithium
• Best known mood
stabilizers
Anticonvulsants
• Carbamazepine
• Sodium valproate
Antipsychotics
• Risperdone
• Topiramate

89. INDICATIONS
 Bipolar disorder
 Manic depressive psychosis
 Recurrent mania
 Cyclic depression
 Acute hypomania
DRUGS INCLUDE :
o Lithium carbonate (Li2CO3)
o Lithium Chloride (LiCl)

90. CONTRAINDICATIONS OF MOOD STABILIZERS
Pregnancy
Cardivascular
disorders
Kidney
disorders
Severe
dehydration
Obesity Diabetes

91. SIDE EFFECTS OF MOOD STABILIZERS
CNS :
- Headache
- Drowsiness
- Slurred speech
- Confusion
CARDIOVASCULAR :
- Hypotension
- Arrhythmias
GIT :
- Dry mouth
- Metallic taste
- Nausea
- Diarrhea

92. NURSE’S RESPONSIBILITIES
 Assess the client’s mood & behavior before & during the course of
Lithium therapy & monitor mood change.
 Prepare the patient for respected side effects in non-anxious
manner.
 Monitor serum lithium levels weekly two three times for first 2
months & afterwards once weekly.
 Monitor input & output and promote fluid intake of 2-3 L/day to
prevent retention.
 Assess the weight & check for edema in legs, ankles & wrists,
monitor for weight plan.

93. ANTI EMETIC DRUGS
 Antiemetic drugs are medicines that ease nausea & vomiting.
 The feeling of nausea results froma complex process in the body and this is why various
drugs have been designed to ease nausea in different situations.
SOME OF THE ANTI EMETICS ARE :
o Sodium citrate
o Orthophosphoric acid
o Bismuth subsalicylate
o Prochlorperazine
o Dexamethasone
o Ondansetron

95. INDICATIONS OF ANTI EMETICS
Motion sickness Stomach flu Pregnancy
Effects of surgery Chemotherapy

96. Sleepiness Dry mouth Constipation
Indigestion Tinnitus
SIDE EFFECTS OF ANTI EMETICS

97. NURSE’S RESPONSIBILITIES
 Monitor for dehydration.
 Advise patient to have bland foods and avoid spicy foods.
 Advise patient to move less and sit upright.
 Assess the type of emesis from the patient.
 Assess the consciousness level of patient before administering the
drug.
 Teach patient to change positions slowly.
 Assess patients neurological status, level of orientation and
reflexes.

98. ANTIPARKINSONIAM DRUGS
INTRODUCTION
 Parkinsonism is a chronic, progressive motor disorder characterized
by rigidity, tremors, hypokinesis.
 If these symptoms worsen, there maybe breathing difficulty and
inability to walk.

99. DRUG DOSE
2 – 3 g/day, BD, Oral.
- Symptoms of hypokinesia, rigidity and tremors resolve on
administration of Levodopa.

100. Dizziness Nausea Dark coloured urine
Unusual dreams Loss of apetite Abdominal cramps
SIDE EFFECTS OF LEVODOPA

101. DRUG DOSE
- 75 – 100 mg, TID, Oral.
ACTION
- Treat Parkinson’s symptoms such as :
• Shakiness
• Stiffness
• Difficulty in moving

102. SIDE EFFECTS OF CARBIDOPA
Dizziness
Loss of
apetite
Constipation Dry mouth Confusion

103. NURSE’S RESPONSIBILITIES
 Assess for parkinsoniam and extra pyramidal symptoms.
 Caution patient to make position change slowly.
 Administer drug with low protein foods.
 Assess for suicidal tendencies.
 Assess for consciousness level of patient before administering drug.
 Patient should be taught not to discontinue antiparkinson drugs
suddenly.

104. CNS STIMULANTS
INTRODUCTION
 CNS stimulants are medicines that stimulate the brain, speeding up
both mental and physical processes.
 They increase energy , improve attention and alertness and elevate
blood pressure, heart rate & respiration rate.

105. 1. AMPHETAMINES
 DRUG DOSE
- 5 – 10 mg/day, Oral
- They promote release of catecholamines from presynaptic nerve terminals &
prevent their reuptake into nerve endings.
 INDICATIONS
- Obesity
- Neurolepsy brain dysfunction syndrome in children.

106. CONTRAINDICATIONS OF AMPHETAMINES
Cardiovascular
diseases
Hypertension Hyperthyroidism Arteriosclerosis Glaucoma

107. SIDE EFFECTS OF AMPHETAMINES
Dizziness Headache Tachycardia Hypertension Diarrhea

108. NURSE’S RESPONSIBILITIES
 Carefully screen potential uses for a history of drug abuse.
 Administer last dose atleast 6 hours before bedtime.
 Inform diabetic patient that insulin/dietary requirement maybe diluted by
amphetamines.
 Caution patient that ability to drive or operate heavy machinery maybe impaired
by the drug.
 Use amphetamines for weight control only after other weight reduction
programme have failed.

109. Conclusion