Pharmacology and the Nursing Process 8th Edition Elsevier
Study online at https://quizlet.com/_522l4c
1. CNS depressants: Sedatives
-inhibits; nervousness, excitability, and irritability
Hypnotics
- induces sleep
-more potent CNS effect
2. Sedative - Hypnotic: Dose dependent - sedatives can become hypnotic if given in a large enough dose
-high dose calms CNS to cause sleep
-low dose calms CNS w/o inducing sleep
Barbiturates
Benzodiazepines
Misc
3. Sleep: REM
Non-REM
REM-interference = fatigue
REM-rebound = vivid dreams
4. Benzodiazepines (Class IV): Sedative - Hypnotic
Anxiolytic
-relieve anxiety
MOA: hypothalamic, thalamic, and limbic systems (GABA receptors inhibiting over stimulation) does
Indication: sedation, skeletal muscle relaxation, anxiety/depression, acute seizure disorder, ETOH withdrawal, short term
insomnia tx
Contra: narrow angle glaucoma, pregnancy
, Pharmacology and the Nursing Process 8th Edition Elsevier
Study online at https://quizlet.com/_522l4c
AE/SE: Fall risk, the greater the dose the greater the AE, not w/ ETOH, MUST TAPPPER to avoid rebound insomnia
Antidote: Flumazelin
S/S tox somnolence, confusion, diminished reflex, coma (O2, ariway management, H2O)
RX - RX: Azole antifungals, ditiazem, pretease inhibitor, macrolide antibiotics, grapefruit juice, CNS depressants, opiods,
olanzapine, rifampin
kava and valerian supplements
5. Flumazelin: (short half life with 1-4 duration)
used to acutely reverse the sedative effect with OD and use with other CNS depressants such as alcohol and barbiturates
0.2 mg prn every 60 sec x 4
managment
0.2 mg over 30 sec wait 30 sec
0.3 mg over 30 sec wait 30 sec
0.5 mg over 30 sec over 60 sec x 6 to equal 3mg
6. Benzodiazepines subclass: Long-acting (tx anxiety)
-diazepam "Valium"
-Clonazepam "Klonopin"
-flurazepam "Dalmana"
Intermediate (tx conscious sedation - amnesic effect)
-alprazolam "Xanax"
-loraepam "Ativan"
-temazepam "Restoril"
Short - acting (tx - sleep aids)
-midazolam "Versed"
-zolpidem "Ambien"
-triazolam "Halcion"
-eszopiclone "Lunesta"
, Pharmacology and the Nursing Process 8th Edition Elsevier
Study online at https://quizlet.com/_522l4c
-ramelteon "Rozerem"
-zaleplon "Sonata"
7. Barbiturates subclass: Ultrashort (tx short surgical anesthesia)
-methoexital IV
-thiopental III
Short (tx sedation and convulsion)
-pentobarbital II
-secobarbital II
Intermediate (tx sedation and convulsion)
-butabarbital III
Long (tx
-phenobarbital IV
-mephobarbital IV
8. Barbiturates (class II,, III, IV): habit forming with a low therapeutic index
MOA: effect the reticular area of the brain-stem to reduce the (GABA) nerve impulses traveling to the cerebral cortex
Indication: seizure, short term anesthesia, inter-cranial pressure reduction, therapeutic coma
Contra: pregnancy, respiratory difficulties, liver and kidney disease,
AE/SE: decreases R.R. Fall risk in the elder - ortho hypo d/t vasodialation, deprived REM increased agitation,
Tox S/S: no antidote, symptomatic and supportive tx
RX-RX increased metabolism of anticoagulants
9. OTC hypnotics: Nonprescription sleep aids containing antihistamine
doxylamine "Unisom"
Study online at https://quizlet.com/_522l4c
1. CNS depressants: Sedatives
-inhibits; nervousness, excitability, and irritability
Hypnotics
- induces sleep
-more potent CNS effect
2. Sedative - Hypnotic: Dose dependent - sedatives can become hypnotic if given in a large enough dose
-high dose calms CNS to cause sleep
-low dose calms CNS w/o inducing sleep
Barbiturates
Benzodiazepines
Misc
3. Sleep: REM
Non-REM
REM-interference = fatigue
REM-rebound = vivid dreams
4. Benzodiazepines (Class IV): Sedative - Hypnotic
Anxiolytic
-relieve anxiety
MOA: hypothalamic, thalamic, and limbic systems (GABA receptors inhibiting over stimulation) does
Indication: sedation, skeletal muscle relaxation, anxiety/depression, acute seizure disorder, ETOH withdrawal, short term
insomnia tx
Contra: narrow angle glaucoma, pregnancy
, Pharmacology and the Nursing Process 8th Edition Elsevier
Study online at https://quizlet.com/_522l4c
AE/SE: Fall risk, the greater the dose the greater the AE, not w/ ETOH, MUST TAPPPER to avoid rebound insomnia
Antidote: Flumazelin
S/S tox somnolence, confusion, diminished reflex, coma (O2, ariway management, H2O)
RX - RX: Azole antifungals, ditiazem, pretease inhibitor, macrolide antibiotics, grapefruit juice, CNS depressants, opiods,
olanzapine, rifampin
kava and valerian supplements
5. Flumazelin: (short half life with 1-4 duration)
used to acutely reverse the sedative effect with OD and use with other CNS depressants such as alcohol and barbiturates
0.2 mg prn every 60 sec x 4
managment
0.2 mg over 30 sec wait 30 sec
0.3 mg over 30 sec wait 30 sec
0.5 mg over 30 sec over 60 sec x 6 to equal 3mg
6. Benzodiazepines subclass: Long-acting (tx anxiety)
-diazepam "Valium"
-Clonazepam "Klonopin"
-flurazepam "Dalmana"
Intermediate (tx conscious sedation - amnesic effect)
-alprazolam "Xanax"
-loraepam "Ativan"
-temazepam "Restoril"
Short - acting (tx - sleep aids)
-midazolam "Versed"
-zolpidem "Ambien"
-triazolam "Halcion"
-eszopiclone "Lunesta"
, Pharmacology and the Nursing Process 8th Edition Elsevier
Study online at https://quizlet.com/_522l4c
-ramelteon "Rozerem"
-zaleplon "Sonata"
7. Barbiturates subclass: Ultrashort (tx short surgical anesthesia)
-methoexital IV
-thiopental III
Short (tx sedation and convulsion)
-pentobarbital II
-secobarbital II
Intermediate (tx sedation and convulsion)
-butabarbital III
Long (tx
-phenobarbital IV
-mephobarbital IV
8. Barbiturates (class II,, III, IV): habit forming with a low therapeutic index
MOA: effect the reticular area of the brain-stem to reduce the (GABA) nerve impulses traveling to the cerebral cortex
Indication: seizure, short term anesthesia, inter-cranial pressure reduction, therapeutic coma
Contra: pregnancy, respiratory difficulties, liver and kidney disease,
AE/SE: decreases R.R. Fall risk in the elder - ortho hypo d/t vasodialation, deprived REM increased agitation,
Tox S/S: no antidote, symptomatic and supportive tx
RX-RX increased metabolism of anticoagulants
9. OTC hypnotics: Nonprescription sleep aids containing antihistamine
doxylamine "Unisom"
