CENTRAL NERVOUS SYSTEM STIMU-
LANTS.Certain drugs stimulate the activity of
various portions of the central nervous system (CNS).
The Manual of the Medical Department (MANMED)
is explicit as to the usage of these drugs in the Navy.
Primary indications for this class of drugs are
narcolepsy, hyperkinesis, and attention deficit
disorders in children.
Central nervous system
stimulants are generally contraindicated in patients
with hypertension, arteriosclerosis, symptomatic
cardiovascular disorders, agitated states, glaucoma, or
history of drug abuse. (See appendix IV, page 12.)
CENTRAL NERVOUS SYSTEM DEPRES-
SANTS.Central nervous system (CNS) depressants
range in depressive action from mild sedation to deep
coma, differing mainly in rapidity, degree, and
duration of action. Any of these CNS depressants may,
in sufficient doses, cause respiratory depression.
Alcohol use while taking CNS depressants should be
Many of the central nervous system
depressants are controlled medications. Refer to the
MANMED for control, custody, and accountability
guidelines for controlled substances.
Barbiturates comprise a widely used group of
CNS depressants. They are used mainly as
sedative-hypnotics, anticonvulsants, anesthetics for
short anesthesia, and may be used in combination with
analgesics to enhance their analgesic effect.
NOTE: Barbiturates may be habit forming.
See appendix IV, page 12, for examples of central
nervous system depressants.
OPIUM AND OPIUM ALKALOIDS.The
activity of opium is primarily due to its morphine
content. The major medical use of opium has been for
its antiperistaltic activity, particularly in diarrhea.
Opium alkaloids, e.g., morphine and codeine, have
replaced opium in medical use. Members of this drug
group are used as analgesics, cough sedatives, and for
certain types of diarrhea. (See appendix IV, pages 12
NOTE: Warn patients taking opium or opium
alkaloids that drowsiness, dizziness, and
blurring of vision may occur. For this reason,
they should not drive or perform other tasks
that require alertness. Also, caution patients
against consuming alcohol and other CNS
Patients should notify their
physician immediately if shortness of breath
or difficulty in breathing occurs.
P S Y C H O T H E R A P E U T I C A G E N T S .
Tranquilizers and mood modifiers are the two primary
groups of psychotherapeutic agents.
peutic agents are classified as major tranquilizers,
minor tranquilizers, and mood modifiers. The mood
modifiers have replaced amphetamines as treatment of
choice for depressive states. (See appendix IV, pages
13 and 14.)
SKELETAL MUSCLE RELAXANTS.
Skeletal muscle relaxants are used in connection with
the treatment of muscle spasm due to various
They may also be used to produce
muscular relaxation during surgical anesthesia.
Skeletal muscle relaxants may cause drowsiness and
impair performance of tasks that require alertness.
(See appendix IV, page 14.)
vascular agents affect the action of the circulatory
system. Most of these agents are highly specialized.
(See appendix IV, pages 14 and 15.)
produce constriction of the blood vessels with
consequent rise in blood pressure. (See appendix IV,
or prevent blood coagulation. Before an anticoagulant
agent is prescribed and its dosage determined,
laboratory testing of the patients blood-clotting
capabilities should be performed.
Examples of commonly used anticoagulants are
listed in appendix IV, page 15.
VITAMINS.Vitamins are unrelated organic
substances that occur in many foods and are necessary
for the normal metabolic functioning of the body.
Vitamins may be water-soluble or fat-soluble. The
majority of vitamins are water-soluble. Water-soluble
vitamins are excreted in the urine and are not stored in
the body in appreciable quantities. The fat-soluble
vitamins (A, D, E, and K) are soluble in fat solvents and
are absorbed along with dietary fats.
vitamins are not normally excreted in the urine and
tend to be stored in the body in moderate amounts.
See appendix IV, page 16, for a listing of several of
the major vitamins and their respective properties.
GENERAL AND LOCAL ANESTHETICS.
Generally speaking, anesthesia means without
feeling. Consequently, we apply the word to drugs
that produce insensibility to pain.
The field of
anesthesia is a highly specialized one.