Home Drug Guide Amphetamine

Drug Guide

Generic Name

Amphetamine

Brand Names Adzenys ER, Adzenys XR-ODT

Classification

Therapeutic: Central nervous system stimulants for ADHD and narcolepsy

Pharmacological: Amphetamine is a sympathomimetic amine with stimulant properties

FDA Approved Indications

  • Attention deficit hyperactivity disorder (ADHD)
  • Narcolepsy

Mechanism of Action

Amphetamine increases the release of norepinephrine and dopamine in the brain by reversing transporter activity and inhibiting reuptake, leading to increased synaptic concentrations and stimulant effects.

Dosage and Administration

Adult: Dosing varies; typically, starting dose is 10-20 mg once or twice daily, titrated based on response and tolerability.

Pediatric: For children 6 years and older, dosing usually starts at 5-10 mg once or twice daily, adjusted as needed.

Geriatric: Use with caution; dosing should start low and titrated carefully owing to potential comorbidities.

Renal Impairment: Use with caution; consider dose adjustments and close monitoring.

Hepatic Impairment: No specific adjustment established; use caution.

Pharmacokinetics

Absorption: Well absorbed orally; peak plasma levels achieved in about 3 hours.

Distribution: Widely distributed, crosses the blood-brain barrier and placental barrier.

Metabolism: Primarily hepatic; minimal metabolism.

Excretion: Renal, with 30-40% excreted unchanged in urine.

Half Life: Approximately 9-14 hours, varies with urinary pH.

Contraindications

  • History of hypersensitivity to amphetamines or other stimulants.
  • Advanced arteriosclerosis.
  • History of drug abuse.
  • Within 14 days of MAOI use.
  • Significant unmanaged hypertension.

Precautions

  • Caution in patients with cardiovascular disease, hypertension, hyperthyroidism, glaucoma, or history of drug dependence.

Adverse Reactions - Common

  • Insomnia (Common)
  • Dry mouth (Common)
  • Anorexia, weight loss (Common)
  • Anxiety, agitation (Common)

Adverse Reactions - Serious

  • Cardiovascular events such as hypertension, tachycardia, or arrhythmias (Serious but less common)
  • Dependency or abuse potential (Serious risk)

Drug-Drug Interactions

  • Monoamine oxidase inhibitors (MAOIs), may cause hypertensive crisis
  • Other CNS stimulants increase effects

Drug-Food Interactions

  • Avoid excessive caffeine intake which can enhance adverse effects

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor cardiovascular status, growth in children, and behavioral effects.

Diagnoses:

  • Risk for hypertension
  • Impaired sleep pattern
  • Potential for substance abuse

Implementation: Administer as prescribed, typically in the morning to minimize insomnia. Monitor for adverse effects.

Evaluation: Assess changes in attention, hyperactivity, and side effects. Adjust dosage accordingly.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Monitor for signs of cardiovascular problems, loss of appetite, or sleep disturbances.
  • Avoid caffeine and other stimulants.
  • Report any signs of abnormal behavior or side effects to healthcare provider.

Special Considerations

Black Box Warnings:

  • Potential for abuse and dependence.
  • Serious cardiovascular events.

Genetic Factors: Metabolism influenced by CYP2D6 enzyme activity.

Lab Test Interference: May affect growth parameters in children; impact on blood pressure readings.

Overdose Management

Signs/Symptoms: Elevated body temperature, hallucinations, agitation, hypertension, tachycardia, seizures.

Treatment: Supportive care, benzodiazepines for agitation or seizures, active cooling, and cardiovascular support as needed.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.