Psychiatric Drugs and Medications Q 25

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As a knowledgeable nurse, you know that you should never give amphetamines in combination with:

  

     A. Oral hypoglycemics

     B. Insulin

     C. MAO inhibitors

     D. Antihypertensives

    

    

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

Option B: Amphetamines mediate their behavioral effects by stimulating dopaminergic signaling throughout reward circuits of the brain. This property of amphetamine relies on its actions at the dopamine transporter (DAT), a presynaptic plasma membrane protein responsible for the reuptake of extracellular dopamine. Recently, researchers have revealed the novel ability of insulin signaling pathways in the brain to regulate DAT function as well as the cellular and behavioral actions of amphetamine.

Option D: Amphetamine enhances recovery after experimental ischemia and has shown promise in small clinical trials when combined with motor or sensory stimulation. Amphetamine, a sympathomimetic, might have hemodynamic effects in stroke patients, although limited data have been published.

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