Psychiatric Drugs and Medications Q 24

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The nurse would monitor for decreased effect of amphetamines when these drugs are given with:

  

     A. Caffeine

     B. Antidiabetic agents

     C. Tricyclic antidepressants

     D. All of the above

    

    

Correct Answer: C. MAO inhibitors

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MAO inhibitors must never be given with drugs affecting the CNS because hypertension can occur. Amphetamine is contraindicated during or within 14 days of MAOI therapy, e.g., phenelzine, due to the risk of hypertensive crisis.

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Option A: Caffeine-amphetamine interactions were studied to determine whether attenuation of amphetamine-induced activity by caffeine pretreatment (30 mg/kg) is the result of increased or decreased sensitivity to amphetamine. Results support a reduction in sensitivity to amphetamine. A cross-tolerance design revealed an asymmetrical interaction between caffeine and amphetamine. Multiple caffeine treatments (30 mg/kg) produced tolerance and attenuation of subsequent amphetamine activity.

Option B: Amphetamines can be given with oral hypoglycemics and insulin as long as blood sugar levels are monitored because these can decrease antidiabetic requirements.

Option D: Tricyclic antidepressants differ in their relative effects on serotonin, norepinephrine, and acetylcholine. The differences are reflected in how the tricyclic antidepressants are used and, most importantly, their propensity to cause certain side effects. For instance, amitriptyline (Elavil) causes more sedation, dry mouth, and constipation than other tricyclic antidepressants.

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