Stimulant central nervous system

The CNS stimulanis include the analeptics, drugs diat stimulate the resiDiratory center of the CNS the amphetamines, drugs widi a liigh abuse potential because of dieir ability to produce euphoria and wakefuhiess and the anorexiants, dru used to suppress die appetite 

Doxapram (Dopram) and caffeine (combination of caffeine and sodium benzoate) are two analeptics used in medicine Doxapram increases the depth of respirations by stimulating special receptors located in the carotid 

Caffeine is a mild to potent CNS stimulant, with the d ree of its stimulating effect dependent on the dose administered. Caffeine stimulates the CNS at all levels, including the cerebral cortex, die medulla, and the spinal cord. Caffeine has mild analeptic (respiratory stimulating) activity. Other actions include cardiac stimulation (which may produce tachycardia), dilatation of coronary and peripheral blood vessels, constriction of cerebral blood v sels, and skeletal muscle stimulation. Caffeine also has mild diuretic activity. 

The anorexiants, such as pheritennirie and pheridime-trazirie, are rionarnphetamine dnr pliaimacologicalfy similar to tlie amphetamines. Lake tlie amphetamines, tlieir ability to suppress tlie apiietite is thou t to be due to tlieir action on tlie ajiiietite center in the hy]X)thalamus. 

The CNS stimulants have limited use in medicine. Examples of CNS stimulants are given in tlie Summary Drug Table Central Nervous %stern Stimulants. 

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Cocaine is the oldest of the local anaesthetics. It is a central nervous system stimulant and is habit-forming. See ecgonine. 

H Airpclilc depressant and central nervous. system stimulant 876... 

A central nervous system stimulant obtained from the leaves of the coca plant)... 

Extension of the alkyl group on the carbon bearing the amine changes the pharmacologic profile. Reductive amination of 1-phenylbutanone-2 (60) with pyrrolidine in formic acid gives pro-litane (61), a central nervous system stimulant agent with antidepressant properties. 

Many alkaloids have pronounced biological properties, and a substantial number of the pharmaceutical agents used today are derived from naturally occurring amines. As a few examples, morphine, an analgesic agent, is obtained from the opium poppy Papaver somnifemm. Cocaine, both an anesthetic and a central nervous system stimulant, is obtained front the coca bush Erythroxylon coca, endemic to upland rain forest areas of Colombia, Ecuador, Peru, Bolivia, and western Brazil. Reserpine, a tranquilizer and antihypertensive, comes from powdered roots of the semitropical plant Rauwolfia serpentina. Ephedrine, a bronchodilator and decongestant, is obtained front the Chinese plant Ephedra sinica. 

Amines can be synthesized in a single step by treatment of an aldehyde or ketone with ammonia or an amine in the presence of a reducing agent, a process called reductive amination. For example, amphetamine, a central nervous system stimulant, is prepared commercially by reductive amination of phenyl-2-propanone with ammonia, using hydrogen gas over a nickel catalyst as the reducing agent. 

Cyclopentamine is an amphetamine-like central nervous system stimulant. Propose a synthesis of cyclopentamine from materials of five carbons or less. 

The term analeptics refers to convulsants and respiratory stimulants (i.e. central nervous system stimulants). They comprise a reverse group of agents (for example amphifrnazole and doxapram (respiratory stimulants) and strychnine, biculline and picrotoxin). Analeptics are mainly experimental drugs. Only amphifrnazole and doxapram are occasionally used for the treatment of acute ventilatory failure. 

Discuss the uses, general drug actions, general adverse reactions, contraindications, precautions, and interactions of the central nervous system stimulants. 

Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking a central nervous system stimulant. 

Discuss ways to promote an optimal response to drug therapy, how to manage common adverse drug reactions, and important points to keep in mind when educating patients about the use of central nervous system stimulants. 

SUMMARY DRUG TABLE CENTRAL NERVOUS SYSTEM STIMULANTS... 

The Patient Receiving a Central Nervous System Stimulant... 

Central nervous system stimulation is the hallmark of acute overexposure to endosulfan in experimental animals. The spectrum of effects includes hyperexcitability, tremors, decreased respiration, tonic-clonic convulsions, and ultimately, death (Boyd and Dobos 1969 Boyd et al. 1970 Ceron et al. 1995 FMC 1958,1959a, 1980a Gilbert and Mack 1995 Hoechst 1970, 1975, 1984e Kiranand Varma 1988 ... 

Similar signs of central nervous system stimulation were observed following exposure to doses of endosulfan as low as 48 mg/kg/day (females) and 81 mg/kg/day (males) during a 6-hour/day, 5-day/week, 30-day exposure period (Hoechst 1985c, 1985d). Diffuse edema was also observed in the brains of males at the 81-mg/kg/day exposure level. However, daily application of up to 62.5 mg/kg/day (males) or... 

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