Methylphenidate Hydrochloride (Ritalin)
ACTION AND USE. This drug is indicated
for use in hyperkinetic children and children with
attention deficit disorders. In children, this drug
acts as a central nervous system depressant. It is
also indicated for narcolepsy in adults.
USUAL DOSE. In children, start with small
doses, usually 5 mg, and then increase the dosage
at a rate of 5 to 10 mg weekly. The doses are given
before breakfast and lunch. The average dose for
adults is 20 to 30 mg per day, which is given 30
to 45 minutes before meals. Adults with narco-
lepsy should take the last dose before 6 p.m.
NOTE: Methylphenidate hydrochloride therapy
should be reevaluated at specific intervals as deter-
mined by the physician. Dosage should be in-
dividualized to fit the needs of each patient.
Dextroamphetamine Sulfate (Dexedrine)
ACTION AND USE. Dextroamphetamine
is primarily indicated for narcolepsy. Because of
its anorectic effect, it is occasionally used to treat
exogenous obesity as an adjunct to diet therapy.
USUAL DOSE. 5 to 60 mg daily in divided
CENTRAL NERVOUS SYSTEM
This large group of drugs ranges in depressive
action from mild sedation to deep coma, differing
mainly in rapidity, degree, and duration of ac-
tion. Many of the central nervous system
depressants are scheduled medications. Chapter
21 of MANMED describes requirements for con-
trol, custody, and accountability of all controlled
substances. Any of these agents may, in sufficient
doses, cause respiratory depression. Any use of
alcohol should be avoided with any of these
medications. NOTE: Barbiturates may be habit
The barbiturates are a widely used group of
CNS depressants that have the same general ac-
tion. They are used mainly as sedative-hypnotics,
anticonvulsants, anesthetics for short anesthesia,
and they may be used in combination with
analgesics to potentate their analgesic effect.
ACTION AND USE. Phenobarbital is a
long lasting barbiturate frequently used in the
treatment of convulsive seizure disorders; this is
the drug of choice in petit mal epilepsy. It is also
used as a hypnotic or sedative.
USUAL DOSE. The hypnotic dose is 50 to
100 mg daily; the sedative dose is 15 to 32 mg in
ACTION AND USE. This barbiturate is in-
dicated for short-term treatment of insomnia; it
is also used as a preanesthetic medication.
USUAL DOSE. 100 mg in a single dose.
ACTION AND USE. Secobarbital is used
the same as pentobarbital and has a rapid hyp-
USUAL DOSE. For insomnia, give 100 mg
at bedtime. For preoperative medication, give 200
to 300 mg 1 to 2 hours prior to surgery.
Phenytoin Sodium (Dilantin)
ACTION AND USE. This is a non-barbitu-
rate anticonvulsant used in the treatment of
seizure disorders. It is preferred to phenobarbital
because it has no hypnotic properties. It is fre-
quently used in combination with phenobarbital
for more effective management of certain epilep-
sies. Phenytoin sodium is the drug of choice in
the treatment and management of grand mal
USUAL DOSE. 300 to 400 mg daily in 2 or
3 divided doses. It may be taken with food or
milk. Dosage should be individualized to provide
Alcohol (Ethyl Alcohol, Ethanol)
ACTION AND USE. In small doses alcohol
stimulates the gastric mucosa, increasing the flow
of juices. Systemically, it is a sedative. Continual
small doses produce hypnotic effects. Its main use
in Navy medicine today is in compounding various
preparations not usually stocked by the pharmacy.
OPIUM AND IT ALKALOIDS
The most important
morphine and codeine.
alkaloids of opium are
All of the other opiate