Stack #152358 Word Scramble
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| Question | Answer |
| sedatives | drugs that have an inhibitory effect on the CNS -can act as a hypnotic if given in large enough doses |
| Symptoms that sedatives reduce | -nervousness -excitability -irritability w/o causing sleep |
| hypnotics | cause sleep |
| dose size | helps determine if drug is sedative or hypnotic, larger doses are typically hypnotic |
| low doses | calm the CNS w/o inducing sleep |
| High doses | calm the CNS to the point of causing sleep |
| Sleep-cycle balance | all sleep needs to be balanced thru all the stages, and sleep drugs will suppress at least one aspect of the cycle |
| Non-REM sleep stage 1 | 2-5% of sleep time -dozing/drifting off to sleep, can be easily awakened |
| Non-REM sleep stage 2 | 50% of sleep time Relaxation, but person can easily be awakened person has occasional REMS and slight eye movements |
| Non-REM sleep state 3 | 5% of sleep time Deep sleep, difficult to wake person vital stats may decrease |
| Non-REM sleep state 4 | 10-15% of sleep time -very difficult to wake person who may be quite groggy if awakened -dreamin occurs, esp about daily events -sleep walking and enuresis can occur |
| REM sleep | REMs occur vivd dreams occur breathing may be irregular |
| Barbiturates | a sedative-hypnotic drug -only a handful commonly used presently b/c of the safety and efficacy of benzodiazepines |
| Categories of Barbiturates | Ultrashort-anesthesia & other uses Short & intermediate-sedative/hypnotic and convulsive condition control Long- sedative/hypnotic, epileptic seizure prophylaxis & other uses Long- sedative/hypnotic, |
| secobarbital | Short acting Barbiturate |
| Barbiturate therapeutic index | is very narrow, effective dose is very close to toxic level |
| how barbiturates work | in brainstem (reticular formation) bariturates inhibit GABA, therefore nerve impulses traveling in the cerebral cortex are also inhibited |
| low doses of barbiturates | sedative effects |
| high doese of barbiturates | hypnotic effects & lowers respiratory rate -alcholo will double the effect of barbituates |
| Barbiturate affect on enzymes | notorious inducer -stimulates liver enzymes that cause the metabolism of many drugs shortening their duration of action |
| severe AEs of Barbiturates | -respiratory depression -reduced REM sleep resulting in agitation (Psychotic) and inability to deal w/ normal stress -overdose produces CNS depression (sleep to coma to death) |
| other therapeutic uses of barbiturates | -anesthesia induction -uncontrollable seizures "Phenobarbital coma" |
| Benzodiazepines | most frequently prescribed sedative-hypnotic for it's favorable drug effect profiles |
| types of benzodiazepines | -sedative-hypnotic -anxiolytic (medication that relieves anxiety) |
| long acting benzodiazepines | estazolam (Prosom) flurazepam (Dalmane) others |
| short acting benzodiazepines | temazepam (Restoril) triazolam (Halcion) |
| Nonbenzoidazepine hypnotics | CNS depressants share many characteristics of benzodiazepines used to treat insomnia |
| types of nonbenzodiazepines | -salepion (Sonata) -zolpidem (Ambien) -eszoplicone (Lunesta) |
| affects of benzodiazepines | depress CNS activity less suppression of REM sleep than barbiturates Do not increase metabolism of other drugs |
| Benzodiazepines uses | -sedation,sleep induction, balanced anesthesia, moderate/conscious sedation -skeletal muscle relaxation (mus. spasm relief) -anxiety, agitation, depression and epilepsy relief, -treatment of alcohol withdrawal |
| AEs of benzodiazepines | mild and infrequent -fall hazard for frail/elderly persons -avoid alcohol and other CNS depressants while taking bezodiazepines |
| Muscle relaxants | -act to relieve pain associ. w/ skeletal muscle spasms |
| Action of muscle relaxants | -CNS site of action -structure and action similar to other CNS depressants -acts directly on skeletal muscle & resembles GABA |
| muscle relaxant uses | -relief of muscle spasms -mgmt of spasticity or severe chronic disorders -MS, Cerebral palsy -work best with concurrent physical therapy |
| dantrolene (Dantrium) | muscle relaxant used in malignant hyperthermia crisis |
| AEs of muscle relaxants | CNS depression symptoms |
| cyclobenzaprine (Flexeril) | commonly used muscle relaxant central acting & treats spasticity |
| baclofen (Lioresal) | -muscle relaxant -oral or intrathecal(spinal) route |
| temazepam (Restoril) | -benzodiazapine used for short-term MGMT of insomnia |
| zaleplon (Sonata) | -nonbeenzodiazepine hypnotic drug -short acting (4 hrs to sleep minumim) -effective up to 5 wks |
| zolpidem (Ambien) | - Short-acting nonbenzodiazepine hypnotic -limit treatment of insomnia to 7-10 days -more grogginess than sonata |
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gfcfnina
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