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Chapter 12 - Pharm
CNS Depressants & Muscle Relaxants
| Question | Answer |
|---|---|
| CNS Depressants are categorized into what two groups | Sedatives & Hypnotics |
| Drugs that inhibit effects of the CNS and reduce nervousness, excitability, and irritability without causing sleep | Sedatives |
| Drugs that cause sleep | Hypnotics |
| Standard drugs that were used for insominia & sedation first introducted in 1903 | Barbiturates |
| Drugs that were found to be habit forming and had a low therapeutic index are known as | Barbiturates |
| The four classes of barbiturates are | Ultrashort, Short, Intermediate, Long |
| Ultrashort Barbiturate, used as anesthesia for short surgical procedures | mephohexital, thiamylal, thiopental |
| Short Barbiturate used as a sedative-hypnotic & to control convulsive conditions | pentobarbital, secobarbital |
| Intermediate Barbiturate used as a sedative-hypnotic & to control convulsive conditions | butabarbital |
| Long Barbiturate used as a sedative-hypnotic and prophylaxis for epileptic seizures | phenobarbital, mephobarbital |
| Therapeutic index for Barbiturates is very narrow? (True/False) | True |
| These drugs take action in the brainstem and inhibit GABA | Barbiturates |
| Low doses of barbiturates give a hypnotic effect? (True/False) | False ( Low doses give a sedative effect) |
| High doses of Barbiturates give a hypnotic effect? (True/False) | True (they also lower respiratory rate) |
| Barbiturates are notorious enzyme inducers which | stimulate liver enzymes & cause metabolism or breakdown which results in a shortend duration of action |
| Indications for Barbiturates are: | Hypnotics, Sedatives, Anticonvulsants,& Anesthesia |
| Adverse Effects of Barbiturates are: | CNS-Drowsiness, lethargy,vertigo, mental depression RESP - respiratory depression, apnea, bronchospasms, cough GI - NVD, constipation OTHER - agranulocytosis, hypotension, Stevens-Johnson syndrome |
| Barbiturates reduce REM Sleep resulting in: | agitation and inability to deal with normal stress |
| Overdose / Toxicity of barbiturates leads to | respiratory depresseion & subsequently respiratory arrest |
| Therapeutic examples of barbiturate overdoses are: | anesthsia induction & "phenobarbital coma" to control seizures |
| Additive interaction effects of Barbiturates are: | Alcohol, anthihistamines, benzodiazepines, opioids, & tranquilizers |
| Inhibiting Interactions of Barbiturates are: | MAOIs (prolong effects) |
| Increased metabolism and barbiturates can reduce anticoagulant response and lead to | possible clot formation |
| Common Barbiturates: | butabarbital (Butisol), pentobarbital (Nembutol), phenobarbital (Luminal), secobarbital (Seconal) |
| The most prescribed CNS Depressant that is a sedative-hypnotic is | Benzodiazepines |
| Benzodiazepines are classified as | Sedative-hypnotic & Anxiolytic |
| There are two types of Sedative Hypnotic Benzodiazepines: | Long acting & Short Acting |
| There is a NONbenzodiazepine Hypnotic used as a CNS Depressant that share characteristics of Benzodiazepines and is also used to treat insomnia | zalepion (Sonata, zolpidem (Ambien), and eszoplicone (Lunesta) |
| Mechanism of Action for Benzoidiazepines are: | Depress CNS activity, affect hypothalamic, thalaic, and limbic systems of the brain, do not suppress REM sleep, Do not increase metabolism of other drugs, and use benzodiazepikne receptors |
| Effects that the Benzodiazepines have are | calming effect to CNS, agitation and anxiety control, reduce excessive sensory stimulation, induce sleep, and induce skeletal muscle relaxation |
| Indications for Benzodiazepines are | sedation, sleep induction, skeletal muscle relaxation, anxiety relief, Treastment of alcohol withdrawal, agitation, depression, epilepsy, balanced anesthesia, and moderate sedation |
| Adverse Effects of Benzodiazepines are | HA, drowsiness, dizziness, vertigo, lethargy, fall hazards, & "hangover effect" |
| CNS Depressants Nursing Implications should include the following: | History including allergies, baseline vital signs, I&O monitoring, orthostatics, assess for contraindications & interactions based on patient's history, give 15-30 minutes before bedtime, rebound REM, caution in elderly, avoid alcohol & CNS depressants |
| Therapeutice Effects to acheive with Benzodiazepines are | increased ability to sleep, fewer awakenings, shorter sleep-induction time, few adverse effects such as hangover effects, & improved sense of well-being |
| Drugs used to relieve pain associated with skeletal muscle spasms are known as | muscle relaxants |
| Muscle relaxansts are central acting in CNS and similar to | CNS depressants |
| Indications for muscle relaxants are | muscle spasms, management of chronic disorders, and for multiple sclerosis & cerbal palsy |
| Muscle Relaxants work best it taken in conjuction with | Physical Therapy |
| Muscle Relaxant used for malignant hyperthermia crisis is | dantrolene (Dantrium) |
| Adverse Effects of Muscle Relaxants are: | Euphoria (feeling of well-being), lightheadedness, dizziness, drowsiness, fatigue, and muscle weakness |
| Most common used muscle relaxants | baclofen (Lioresal), cyclobenzaprine (Flexeril), dantrolene (Dantrium), metaxalone (Skelaxin), tizaniine (Zanaflex) |
Created by:
LILES
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