Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Stack #73359
Chapter 27 Sedatives and Hypnotics
| Drug | Action |
|---|---|
| Sedative | produce diminished responsiveness to stimuli without producing sleep |
| Another name for antianxiety agent | anxiolytic |
| Hypnotic | more incense CNS depressant effect, usually produces sleep |
| sedative-hypnotics | produce either diminished responsiveness or intense CNS depressant effect based upon dose administered |
| barbiturates | reticular formation area of brain; reduces nerve impulses to cerebral cortes and inhibits nerve impulse transmission by potentiating inhibitory effect of GABA |
| Give 3 examples of barbiturates | Phenobarbital - Luminal; secobarbital - seconal; pentobarbital - nembutal |
| Ultra short acting barbiturates are usually used as | IV anesthetics |
| Short and intermediate-acting barbiturates are used | to treat insomnia, no hangover effect |
| Which barbiturates are often used with versed? | Ultra-short acting w/ anesthesia |
| Long-acting barbiturates are used to treat | convulsive disorders such as epilepsy |
| Major side effects of barbiturates | Excessive CNS depression |
| CNS depression symptoms include | drowsiness, lethargy, dizziness, "hangover" |
| Barbiturates reduce seizures by | raising seizure threshold |
| what paradoxical restlessnes or excitment | When meds intented to have one reaction, have the opposite effect |
| What do barbiturates do to the REM sleep cycle? | depresses REM sleep, you don't get a good night sleep without REM sleep |
| can you stop barbituates immediatly? | No, barbiturates have to be tapered off |
| S/S of toxicity of barbiturates | Confusion, excitement, deep sleep, coma, pupil constriction, clammy skin, hypotension |
| when taking barbiturates, what is meant by rebound phenomena? | increase in REM sleep and dreams become nightmares |
| Name 2 drugs that have drug-drug interactions when taking barbiturates | Coumadin and dilutin because they are metabolized in the liver |
| Benzodiazepines action | hypothalmic, thalmic, and limbic system; depresses CNS |
| Benzodiazepines action resemble which receptors? | GABA receptors which cause system to relax |
| Benzodiazepine generic name valium | diazepam |
| Benzodiazepine generic name Dalmane | flurazepam |
| Benzodiazepine generic name for Ativan | Lorazepam |
| Benzodiazepine generic name for Versed | midazolam |
| Benzodiazepine generic name for Restoril | Temazepam |
| Benzodiazepine generic name for Halcion | Triazolam |
| The effects of benzodiazepines | Useful hypnotic agent, calms CNS, controls anziety and agitation, relax skeletal muscle |
| Is benzodiazepines safe with medication metabolized in the liver? | Yes |
| Benzodiazepines are useful for withdrawal of what drug? | Alcohol |
| How do benzodiazepines affect the REM sleep cycle? | Benzodiazepines do not affect REM sleep |
| Name some side effects of benzodiazepines | Vertigo, dizziness, over sedation, excitement in elderly |
| Are benzodiazepines safe during pregnancy | No, it is teratogenic |
| Which benzodiazepine has the worst side effects? | Halcion (trizolam), anterograde amnesia, paradoxical psychiatric reaction, rebound sleep disorders |
| Can benzodiazepines cause dependancy? | Yes, both psychological and/or physical dependence |
| Overdose of benzodiazepines s/d | somnolence, confusion, coma, diminished reflexes, death |
| What is somnolence? | A state of feeling drowsy |
| How is overdose of benzodiazepines treated for conscious client? | syrup of Ipecac; activated charcoal with gastric lagave; romazicon |
| Name a benzodiazepine antagonist | Romazicon |
| If client is unconscious what IV drug can be used? | If flumazenil (Romazicon) |
| Nonbenzodiazepines action | Act on GABA similar to barbiturates and benzodiazepines |
| Nonbenzodiazepines use: | Used only as a sleeping aid |
| Warning about Nonbenzodiazepines | devote at least 8 hours to sleep |
| Examples of nonbenzodiazepines | Eszopiclone (Lunesta), zaleplon (Sonata), zolpidem tartrate (Ambion) |
| Eszopiclone (Lunesta) is indicated for people: | having diffulty falling/staying asleep |
| Time of effect of eszopiclone (Lunesta) | Lunesta peaks in 1 hour, has no cumulative effect |
| eszopiclone (Lunesta) special instruction | Take Lunesta when you can devote 8 hr. of uninterrupted sleep; take immediatly before going to bed |
| Rapid withdrawal of eszopiclone (Lunesta) | restlessness, anxiety, irratibility |
| Zalepion (Sonota) is indicated for | insomnia |
| Side effects of Zalepion (Sonota) | dizziness, amnesia, anxiety, abnormal thinking, difficulty with concentration, euphoria, agitation |
| Limitations of Zalepion (Sonota) | limit use to 5 weeks |
| Drug-drug interactions with Zalepion (Sonota) | Tagament, Rifampin, CNS depressants |
| Zolpidem Tartrate (Ambien) indications | Short term treatment of insomnia; no withdrawal syndrome; memory impairment - new warning |
| Special instructions for taking Zolpidem Tartrate (Ambien | Immediatly before bed; 8 hrs to sleep; take on empty stomach |
| Drug-drug interactions with Zolpidem Tartrate (Ambien | Ketoconazole levels increase; CNS depressants |
| Alcohol potentiates what action | CNS depressant |
| Chloral Hydrate is an old sleep agent used for: | short-term therapy, doesn't supress REM sleep; Has short duration of action; rare hangover, may need to adjust anticoagulant dose |
| Non prescription sleep aid: | diphenhydramine, used for antihistamine, used for side-effect (sedation) |
| Warning about diphenhydramine use for sleep aids | Some contain acetominophen |
| Max dose for acetominophen | 4 gram/day |
| Cautions for OTC sleep aids | Asthma, glaucoma, don't use more than 2 weeks |
| Sefety Implementations for clients using sedatives/hypnotics | side rails up x2; help with embulation; avoid OD by not leaving med by bedside; promote sleep environment |
| Teach clients to avoid what to promote better sleep | CNS stimulates such as caffiene |
| what must the nurse obtain before giving a sedatvie or hypnotic? | prescription |
| what should the nurse determine if the client is having diffiuclty sleeping? | casue and nature of the sleep pattern disturbance |
| possible causes that a client is having difficulty sleeping is? | anxiety, hunger, pain, distraction, unfamiliar surrounding, and effects of other drugs client is receiving |
| care should be taken in the use of prn orders for? | sedative and hypnotics |
| what type of insuffient type of seelp may occur using hypnotics? | REM sleep |
| Who requires special car with sedatives and hypnotics? | children and elderly |
| childrens and elderly activites and ambulation must be monitored because they may become? | confused or unsteady in their gait |
| What are the adverse effects of barbiturates? | CNS depression, hypersensitivity reaction, and excitement |
| What should the elderly be observed for that sometimes occures with barbiturates? | paradoxical (alternating) excitment |
| Paradoxical (alternating) excitement with barbiturates may be a side effect and a higer dosage will not produce what? | sedation |
Created by:
Robi-d
Popular Nursing sets