CNS Stimulant

• Pathophysiology of Attention Deficit Hyperactivity Disorder and narcolepsy

  • Risk Factors: Genetics, Male, Environmental Factors (Exposure to smoking)
  • Dysregulation of neurotransmitters: Serotonin, Norepinephrine, Dopamine
• Narcolepsy


  Characterized by falling asleep during normal waking activities, such as driving a car or talking with someone. Sleep paralysis, the condition of muscle paralysis that is normal during sleep, usually accompanies narcolepsy and affects the voluntary muscles. The narcoleptic is unable to move and may collapse.
• Amphetamines


  • Stimulate the release of the neurotransmitters norepinephrine and dopamine from the brain and sympathetic nervous system (peripheral nerve terminals) and inhibit the reuptake of these transmitters
  • Ordinarily cause euphoria and increased alertness
  • The half-life of amphetamines varies from 9 to 13 hours
• Amphetamines


  • Amphetamine Sulfate
  • Dextroamphetamine Sulfate
  • Lisdexamfetamine dimesylate
• Amphetamine-Like Drugs for Attention-Deficit/Hyperactivity Disorder and Narcolepsy

  • Methylphenidate: the most frequently prescribed drug used to treat ADHD, also used to treat narcolepsy
  • Dexmethylphenidate: Both are given to increase a child's attention span and cognitive performance
  • Modafinil: Amphetamine-like stimulant that increases wakefulness in patients with sleep disorders such as narcolepsy
• Pharmacodynamics of Methylphenidate

  • Helps to correct ADHD by decreasing hyperactivity and improving attention span. It is also a treat for narcolepsy
  • Amphetamine-like drugs are considered generally more effective in treating ADHD than are amphetamines which are generally avoided because they have a higher potential for abuse, habituation, and tolerance
  • Methylphenidate potentiates the action of CNS stimulants, such as caffeine, and inhibits the metabolism of some barbiturates, such as phenobarbital, which can lead to increased blood levels and potential toxicity
• Anorexiants


  Cause a stimulant effect on the hypothalamic and limbic regions of the brain to suppress appetite
• Analeptics


  CNS stimulants that mostly affect the brainstem and spinal cord but also affect the cerebral cortex. The primary use of an analeptic is to stimulate respiration
• Anorexiant drugs for obesity


  • Benzphetamine hydrochloride
  • Dethylpropion hydrochloride
  • Phentermine hydrochloride
  • Phentermine-topiramate
  • Phendimetrazine
  • Liraglutide
  • Naltrexone Hydrochloride/Bupropion hydrochloride
  • Serotonin 2C Receptor Agonist: Lorcaserin
• Analeptic drugs


  • Methylxanthines: Caffeine Citrate - For neonatal apnea, Theophylline - For bronchospasm prophylaxis, COPD, asthma, status asthmaticus and neonatal apnea
  • Doxapram - For post anesthesia respiratory depression
• Side Effects of Anorexiants and Analeptics

  • Anorexiants: Nervousness, Restlessness, Irritability, Insomnia, Heart Palpitations, Hypertension
  • Analeptics: Nervousness, Restlessness, Tremors, Twitching, Palpitations, Insomnia, Diuresis, GI irritation, Tinnitus, Dysrhythmias, Convulsions, psychological dependence