What medications should the client avoid while on a CNS stimulant drug? Select all that apply.

Rationale: A. Decongestants: Decongestants such as pseudoephedrine have sympathomimetic properties that stimulate the central nervous system and increase blood pressure and heart rate. When combined with CNS stimulants, there is an additive effect that can lead to hypertension, tachycardia, and increased risk of cardiac complications. This heightens the risk of overstimulation and adverse cardiovascular effects. B. SSRI: Selective serotonin reuptake inhibitors primarily affect serotonin levels and are commonly used to treat depression and anxiety. While caution is warranted due to a potential (though low) risk of serotonin syndrome when combined with certain stimulants, SSRIs are not universally contraindicated. They are often co-prescribed under close monitoring. C. MAOI: Monoamine oxidase inhibitors significantly increase levels of norepinephrine, dopamine, and serotonin by preventing their breakdown. When combined with CNS stimulants, this can cause excessive accumulation of catecholamines, leading to hypertensive crisis, severe headache, stroke, or even death. A washout period is required before initiating stimulant therapy. D. Calcium channel blocker: Calcium channel blockers reduce blood pressure and myocardial contractility by inhibiting calcium influx in cardiac and smooth muscle cells. They do not have a direct stimulatory effect on the CNS and are sometimes used to counteract stimulant-induced hypertension. There is no major contraindication when used with CNS stimulants. E. Glucocorticoids: Glucocorticoids primarily exert anti-inflammatory and immunosuppressive effects and do not directly stimulate the CNS in the same manner as stimulant drugs. While long-term use may cause mood changes or insomnia, they do not produce significant additive stimulant effects or dangerous interactions when combined with CNS stimulants.