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ch.12
pharm.
| Question | Answer |
|---|---|
| drugs that have an inhibitory effect on the CNS to the degree that they reduce | nervousness, excitability, irritability w/o causing sleep |
| cause sleep | hypnotics |
| what can become a hypnotic if it is given in large doses | sedative |
| sedative-hypnotic calms the CNS w/o inducing sleep | low doses |
| sedative-hypnotic calms the CNS to the point of causing sleep | high doses |
| first introduced in 1903, were the standard drugs for insomnia and sedation | barbiturates |
| habit forming,low therapeutic index | barbiturates |
| what are the four categories of barbiturates | ultrashort,short,intermediate,long |
| anesthesia for short surgical procedures, other uses | ultrashort |
| sedative-hypnotic and control of convulsive conditions | short |
| sedative-hypnotic and control of convulsive conditions | intermediate |
| sedative-hypnotic, epileptic seizure prophylaxis, other uses as well | long |
| have a very narrow therapeutic index | barbiturates |
| barbiturates site of action | brainstem (reticular formation) |
| barbiturates drug effects | sedative effects-low doses, hypnotic effects (also low respiratory rate)-high doses and result is shortened duration of action |
| combined with alcohol is extremely dangerous | barbiturates |
| A.E. for barbiturates | respiratory depression |
| anything with barbital | barbiturates |
| additive effects of barbiturates | ETOH, antihistamines,benzodiazepines, opioids, tranquilizers |
| uncontrolled seizures | phenobarbital coma |
| alot safer and does not suppress REM sleep | benzodiazepines |
| sedative-hypnotic and anxiolytic(medication that relieves anxiety) | classification of benzodiazepines |
| only drug approved for long term use is | lunesta |
| long acting drugs are | estazolam (prosom), flurazepam (Dalmane), |
| short acting drugs are | temazepam (Restoril), triazolam (halcion) |
| CNS depressants | nonbenzodiazepine hypnotics |
| Nonbenzodiazepine hypnotics | zalepion (Sonata), zolpidem (Ambien), eszoplicone (Lunesta) |
| do not suppress REM sleep as much as barbiturates do | benzodiazepine receptors |
| benzodiazepines indications | sedation,sleep induction, skeletal muscle relaxation, anxeity relief, treatment of alcohol withdrawl, agitation, depression, epilespy, balanced anesthesia, moderate and conscious sedation |
| benzodiazepines adverse effects | headache, drowsiness, dizziness, vertigo, lethargy, fall hazards for frail elderly patients, hangover effect |
| benzodiazepines nursing implications | give 15 to 30 minutes before bedtime for max. effectiveness in inducing sleep |
| benzodiazepines nursing implications | most of these cause REM rebound and a tired feeling the next day, use with caution in the elderly |
| benzodiazepines nursing implications | patients should be instructed to avoid alcohol and other CNS depressants |
| benzodiazepines nursing implications | check with physician before taking any other medications, including OTC medications |
| benzodiazepines nursing implications | rebound insomnia may occur for a few nights after 3-4 week regimen has been discontinued |
Created by:
Aman9ms
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