AdverseEffectsMost of the CNS stimulants produce adverse reactionsthat are extensions of their therapeutic effect. These agentsproduce convulsions that can be followed by coma anddeath. Convulsions produced by this class ofagents (withthe exception of strychnine) are usually tonic-clonic andare uncoordinated. In some cases, the convulsions arepreceded by marked stimulation of respiration,tachycardia, and excessive pressor effects. Theuncontrolled excitation that occurs after accidentalorintentional strychnine ingestion (in the absence
Adverse Effects Most of the CNS stimulants produce adverse reactions that are extensions of their therapeutic effect. These agents produce convulsions that can be followed by coma and death. Convulsions produced by this class ofagents (with the exception of strychnine) are usually tonic–clonic and are uncoordinated. In some cases, the convulsions are preceded by marked stimulation of respiration, tachycardia, and excessive pressor effects. The uncontrolled excitation that occurs after accidentalor intentional strychnine ingestion (in the absence
of normal inhibition) results in characteristic convulsionsIn humans, in whom extensor muscles are normallydominant, tonic extension of the body and all limbs isobserved. This hyperextension is known as opisthotonosThe primary therapeutic consideration after strychninepoisoning is to prevent convulsions, which may be fatal.Diazepam and clonazepam appear to be moderatelyeffective in preventing strychnine convulsions, and eitherof these is the agent of choice.Barbiturates are often used to treat overdoses of all of theanalepticstimulants
of normal inhibition) results in characteristic convulsions. In humans, in whom extensor muscles are normally dominant, tonic extension of the body and all limbs is observed. This hyperextension is known as opisthotonos. The primary therapeutic consideration after strychnine poisoning is to prevent convulsions, which may be fatal. Diazepam and clonazepam appear to be moderately effective in preventing strychnine convulsions, and either of these is the agent of choice. Barbiturates are often used to treat overdoses of all of the analeptic stimulants
.Aat its extreme, it consists of a characteristic posture inwhich the back is arched and only the back ofthe headand the heels are touching the surface on which thevictimislying
at its extreme, it consists of a characteristic posture in which the back is arched and only the back of the head and the heels are touching the surface on which the victim is lying
Nikethamide(Coramine）Pharmacologic actionDirect: Stimulate apneustic center in medullaoblongata, improve the sensitivity ofapneustic center responding to CO2Indirect: Stimulate baroreceptor in carotid sinus.then reflexly stimulate apneustic center.UsesDepression of apneustic center caused byvarious reasons.SideeffectsVery few side effects, but overdosage causes increase ofBP, tachycardia, arrhythmias, vomiting, musculartwitches, stiff or convulsion
Pharmacologic action Direct: Stimulate apneustic center in medulla oblongata, improve the sensitivity of apneustic center responding to CO2 . Indirect: Stimulate baroreceptor in carotid sinus, then reflexly stimulate apneustic center. Uses Depression of apneustic center caused by various reasons. Side effects Very few side effects, but overdosage causes increase of BP, tachycardia, arrhythmias, vomiting, muscular twitches, stiff or convulsion. Nikethamide (Coramine)