Drug Information Table: Amphetamines (Adderall) - PDF

Drug Information Table CNS stimulant Amphetamines – amphetamine/dextroamphetamine sulfate (Adderall) THERAPEUTIC USE Attention-deficit/hyperactivity disorder (ADHD) in both adults and chil- dren Narcolepsy ADVERSE DRUG Insomnia, nervousness REAC...

Drug Information Table CNS stimulant Amphetamines – amphetamine/dextroamphetamine sulfate (Adderall) THERAPEUTIC USE Attention-deficit/hyperactivity disorder (ADHD) in both adults and chil- dren Narcolepsy ADVERSE DRUG Insomnia, nervousness REACTIONS Weight loss, suppressed growth in children Hypertension, tachycardia, heart palpitations Toxicity – psychosis, dysrhythmias, seizures Tolerance, dependence, and high risk for abuse Withdrawal – occurs when drug is stopped abruptly (depression) INTERVENTIONS Arrange daily doses to allow for nighttime sleep Monitor weight (and for children, height) Drug “holidays” in children may be necessary to prevent growth sup- pression Monitor vital signs Monitor dosage carefully Treat symptoms with antipsychotic, antihypertensive agents Monitor use of this drug carefully Taper dose when discontinuing drug Monitor for signs of depression, fatigue when drug is stopped ADMINISTRATION Available in both regular tablets and a sustained-release form (Adderall XR) Administer drug whole; instruct client not to chew or crush drug CLIENT INSTRUC- Instruct clients to avoid caffeine TIONS Instruct clients to take the drug as early in the day as possible (last dose no later than 4 p.m.) Instruct client/family to report anorexia, weight loss to provider Arrange largest meals for times of day when appetite is greatest Instruct clients to report cardiovascular effects to provider Instruct client to take only as directed and not to increase dosage Advise client regarding abuse potential Instruct client not to stop this drug abruptly, but to taper dose CONTRAINDICA- Allergy to amphetamines TIONS Moderate or severe hypertension Cardiovascular disease Structural cardiac defects (children) Hyperthyroidism History of drug abuse Clients currently taking or have used MAOI (phenelzine) within past 14 days Glaucoma PRECAUTIONS Mild hypertension INTERACTIONS Current use or use within 2 weeks of MAOI antidepressants may cause severe hypertension Increased chance of cardiac effects when taken with other stimulants, digoxin, beta blockers, or tricyclic antidepressants Ascorbic acid, ammonium chloride decrease elimination of amphet- amines Sodium bicarbonate, acetazolamide increase amphetamine effect