Transcript Migraine Headaches Serotonin agonist

 Describe
the actions, intended effects, and
related nursing care for patients receiving
CNS Stimulants.
 Discuss
the nursing process as it relates to
patients receiving CNS stimulants in various
care situations.
 Drugs
that stimulate a specific area of the brain
or spinal cord
 Sympathomimetic
drugs
According to:
•
•
•
Structural similarities
or
Site of therapeutic action in the central nervous
system (CNS)
or
Major therapeutic usages


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
Analeptics
– Reversal of anesthesia-induced respiratory
depression
Anorexiants
– Thought to suppress the appetite control center in
the brain
ADHD
– Stimulate the areas in the brain responsible for
mental alertness and attentiveness
Narcolepsy
– Increase mental alertness
Migraine headaches
– Caffeine, co-administered with other drugs, used
to treat headaches
 Wide
range, dose related
 Tend
to “speed up” body systems
 Common
–
adverse effects include:
Palpitations, tachycardia, hypertension, angina,
dysrhythmias, nervousness, restlessness,
anxiety, insomnia, nausea, vomiting, diarrhea,
dry mouth, increased urinary frequency, others
ADHD
 amphetamine
(Adderall, others)
 methylphenidate
 atomoxetine
(Concerta, Ritalin)
(Strattera)
Narcolepsy
 modafinil
(Provigil)
Anorexiants
 sibutramine
(Meridia)
 phentermine
(Ionamin)
 orlistat


(Xenical)
Lipase inhibitor, not a CNS stimulant
Also used to treat obesity
 Migraine
Headaches
Serotonin agonist
–
Dissolvable wafers, nasal spray, and self-injectable
forms
–
Provide specific teaching about correct administration
–
Foods containing tyramine should be avoided
–
Patients should keep a journal to monitor response to
therapy
Antimigraine (serotonin agonists)
 almotriptan
(Axert)
 eletriptan (Relpax)
 frovatriptan (Frova)
 naratriptan (Amerge)
 rizatriptan (Maxalt)
 sumatriptan (Imitrex)
 zolmitriptan (Zomig)
Responsive Respiratory Depression Syndromes:
Analeptics
 This
use is now less frequent
 Still used for neonatal apnea
 doxapram (Dopram)
 Methylxanthines, such as aminophylline,
theophylline, and caffeine

Found in:
 OTC drugs
 Combination prescription drugs
 Foods

Use with caution in patients with history of:
 Peptic ulcer
 Recent myocardial infarction
 Dysrhythmias

Many uses

Neonatal apnea

Respiratory depression in adults

Enhance effects of analgesics and migraine
medications

CNS stimulation (No-Doze, Vivarin)
 Assess
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for:
Potential contraindications
Potential interactions, including herbal therapies
Conditions such as abnormal cardiac rhythms,
seizures, palpitations, liver problems
For children, assess baseline height and weight

Drugs for ADHD

Should be given at least 6 hours before bedtime to reduce
problems from insomnia

May cause dry mouth; frequent oral care is needed

Take on an empty stomach, 30-45 minutes before meals

Drug “holidays” may be ordered

Parents should keep a journal to note child’s response to therapy

Obesity - With orlistat:
–
Follow instructions for diet and exercise
–
Adverse effects may be reduced if dietary fat is
limited to 30% of total intake
–
Take with meals that contain fat
–
Fat-soluble vitamin supplementation may be needed
 Monitor
for therapeutic responses
 Monitor
for adverse effects
A
patient with narcolepsy will begin
treatment with a CNS stimulant. Which of
the following adverse effects is this patient
likely to encounter?
 a.
bradycardia
 b. nervousness
 c. mental clouding
 d. drowsiness at night
 The
parents of a 10-year old boy are
concerned about the adverse effects of the
medication their son is taking for ADHD.
Discuss what they will need to monitor while
he is taking medications for this condition.
A
patient calls the headache clinic because
she is unhappy about her medication. She
says, “I’ve been taking zolmitriptan (Zomig)
to prevent headaches, but I am still having
them.” Discuss what she needs to know
about the proper use of this drug.