Stimulants short-acting

Prandial insulin releasers (meglitinides) Repaglinide, nateglinide Stimulate insulin secretion (rapid and short-acting < 6 h) Oral... 

If contractions are frequent, prolonged, or excessive, die infusion is stopped to prevent fetal anoxia or trauma to die uterus. Excessive stimulation of die uterus can cause uterine hypertonicity and possible uterine rupture. The nurse places die patient on her side and provides supplemental oxygen. The effects of die drug diminish rapidly because oxytocin is short acting. 

Cocaine or stimulant intoxication may require administration of a small dose of a short-acting benzodiazepine (e.g., lorazepam 1 to 2 mg) for agitation or severe anxiety. Antipsychotics (e.g., haloperidol 2 to 5 mg) should be used only if psychosis is present. If hyperthermia is present, initiate cooling measures. 

Initial response to short-acting stimulant formulations (e.g., methylphenidate and dextroamphetamine) is seen within 30 minutes and can last for 4 to 6 hours.13,14 This short duration of effect frequently requires that short-acting stimulant formulations be dosed at least twice daily, thus increasing the chance of missed doses and non-compliance. Further, patients using any stimulant formulation but especially shortacting formulations can experience a rebound effect of ADHD symptoms as the stimulant wears off.14... 

Short-Acting Stimulants Methylphenidate Generic 5-, 10-, or 20-mg tab twice daily ... 

The short-acting / -agonists (Table 80-1) are the most effective broncho-dilators available. /J2-Adrenergic receptor stimulation activates adenyl cyclase, which produces an increase in intracellular cyclic adenosine monophosphate. This results in smooth muscle relaxation, mast cell membrane stabilization, and skeletal muscle stimulation. 

Substance-Induced Anxiety Disorder. Numerous medicines and drugs of abuse can produce panic attacks. Panic attacks can be triggered by central nervous system stimulants such as cocaine, methamphetamine, caffeine, over-the-counter herbal stimulants such as ephedra, or any of the medications commonly used to treat narcolepsy and ADHD, including psychostimulants and modafinil. Thyroid supplementation with thyroxine (Synthroid) or triiodothyronine (Cytomel) can rarely produce panic attacks. Abrupt withdrawal from central nervous system depressants such as alcohol, barbiturates, and benzodiazepines can cause panic attacks as well. This can be especially problematic with short-acting benzodiazepines such as alprazolam (Xanax), which is an effective treatment for panic disorder but which has been associated with between dose withdrawal symptoms. 

Children naive to stimulant treatment may be started directly on a sustained-release formulation. Starting doses could be any of the following 5 mg of Dexedrine spansules once in the morning, or 5 mg of Adderall bid, or 18 mg of Concerta, which is equivalent to MPH 5 mg tid. Before the availability of Concerta, it had become common practice to combine short-acting MPH with MPH-SR20 to increase efficacy and duration of effect and to allow for more flexible dosing. 

With short-acting agents, such as triazolam, numerous reports have detailed increased daytime anxiety and early morning insomnia ( 108, 112, 296, 297, 298, 299, 300, 301 302). Because these are the opposite of the intended therapeutic effect, they may not be attributed to the drug and may actuaily reinforce its use. CNS stimulation has been reported in 2.8% of patients given 30 mg flurazepam (279). 

The liver, for the amide-type anesthetics, or plasma esterases, for the ester-type, can eliminate large amoimts of local anesthetics. Within 30 to 60 minutes sufficient elimination of the overdose usually occurs to make the CNS stimulation or depression short-lived. Management objectives should therefore center on temporary respiratory and cardiovascular support. Administration of supplemental oxygen usually rapidly restores normal CNS function. In patients in whom cardiovascular collapse is evident, vasopressor therapy may take the form of metaraminol bitartrate 1% (Aramine) given intramuscularly or intravenously. The effect of this potent short-acting vasopressor lasts 20 to 60 minutes, depending on route of administration. 

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