Okay.
In this video, we are going to cover the remaining Mental health medications that are part of
our Pharmacology Flash Cards Edition 2.0.
We're going to talk about ADHD medications, medications for alcohol abuse and opioid dependence,
as well as medications to help with smoking cessation.
If you are following along with cards, we are on card 65 in the nervous system.
First, let's talk about central nervous system stimulants, which are used to treat ADHD as
well as conduct disorder.
Medications that fall within this class include methylphenidate and amphetamine mixtures.
These medications stimulate the central nervous system as well as the respiratory system to
increase mental alertness and to increase attention span in patients who have ADHD.
So when I look at these drug names, which are, again, methylphenidate and amphetamine
mixture, it really just reminds me of methamphetamines, right, or meth, which will amp you up if you
took those.
So that's basically what these medications do.
They really stimulate the central nervous system as well as the respiratory system to
help people with their alertness and their ability to concentrate.
So I find it fairly easy to remember what these medications do, just based on the drug
names.
In terms of side effects, side effects can include insomnia, dysrhythmias, and then perhaps
most importantly, decreased appetite and weight loss.
These medications also carry a black box warning because drug abuse as well as dependence is
common with these ADHD medications.
In terms of teaching, we're not going to want to give this medication at night because of
that side effect of insomnia, so giving it in the morning would definitely be better
for the patient.
We would give the medication about 30 to 45 minutes before meals, and we're definitely
going to want to monitor the patient's weight during therapy because weight loss is a very
common and important side effect to remember with ADHD medications.
Okay, let's now talk about maintenance medications for alcohol abuse.
Medications that fall within this class include disulfiram, naltrexone and acamprosate.
Keep in mind these medications are not for an acute alcohol withdrawal situation, so
if a patient is undergoing acute alcohol withdrawal, then our attention is really focused on trying
to decrease their vital signs and prevent seizures.
So we would give them medications such as benzodiazepines, beta blockers and anti-epileptics.
These medications that I'm going to go over are really for long-term abstinence from alcohol,
so they work a little differently.
So disulfiram works as a deterrent because if the patient ingests alcohol while they're
taking disulfiram, they will get this very unpleasant reaction which includes vomiting,
palpitations, sweating, and hypotension.
In terms of how naltrexone works, it works by helping to suppress the patient's craving
for alcohol.
And acamprosate helps to decrease abstinence symptoms, which can include anxiety and restlessness.
So one way that I remember acamprosate is I think of someone being sent to a camp to
try to stay off of alcohol and at that camp, they were given acamprosate.
So that's just my little tip for remembering what this medication is for.
Okay, now let's talk about maintenance medications that are used for opioid dependence, so this
includes medications such as buprenorphine and methadone.
These medications are not only used for opioid withdraw and maintenance, they can also be
used in the management of patients who have chronic severe pain.
They work by binding to opioid receptors in the CNS which helps to decrease pain but also
results in and central nervous system depression.
Because it is binding to opioid receptors, we're going to get the same type of side effects
that we would see with opioid analgesics, so this includes sedation, confusion, constipation,
hypotension, and respiratory depression.
There is a black box warning for this medication because it can cause respiratory depression.
It can also result in prolonged QT intervals, so it does cardiac depression as well.
Keep in mind that the antidote for these medications is naloxone, okay, or Narcan is the brand
name.
So it's important that if a patient is going to be on one of these medications that you
really keep an eye on their vital signs, their pain level, as well as their respiratory status.
And then you want to advise your patient to increase their fiber and fluid intake to help
prevent constipation, which is very common with this medication.
Alright.
Now, let's talk about a nicotine agonist, which is varenicline or Chantix.
This medication is used to promote smoking cessation.
It works by binding to nicotine receptors, which in turn decreases an individual's desire
to smoke.
So the little Cool Chicken hint that's on this card here is, "Varenicline, make sure
veins clean of nicotine."
So, hopefully, that will help you remember what this medication is for, as well.
In terms of side effects, varenicline can cause anxiety, depression, irritability, GI
upset, insomnia, and muscle pain.
This medication did carry a black box warning for many years due to neuropsychiatric events.
So if your patient is on this medication, you'll just want to monitor them for depression
or suicidal thoughts.
Also, keep in mind there's one other medication that we talked about when we covered medications
for depression that also helps with smoking cessation, and that is bupropion, and you
can find that on card number 58.
Also, keep in mind that there are nicotine replacements that are available over the counter,
including gums, patches, and nasal spray.
Okay.
That is it for the mental health medications in our nervous system section.
Next up, we will be talking about analgesics.
Thanks so much for watching!