Anxiolytic & Hypnotic Agents Flashcards
Define anxiolytic
Drugs used to depress the central nervous system; prevents the signs and symptoms of anxiety
Define hypnotic
Drugs used to depress the CNS; causes sleep
What is sedation?
Loss of awareness and reaction to environmental stimuli
What are the sites of actions of benzodiazepines and barbiturates?
Epinephrine, norepinephrine, acetylcholine, serotonin, GABA
What is the action of benzodiazepines?
Act in the limbic system and the RAS Make GABA more effective Causes interference with neuron firing Lower doses cause anxiolytic effects Higher doses cause sedation and hypnosis
What are the indications for use for benzos?
Anxiety disorders
Alcohol withdrawal
Hyper excitability and agitation
Pre operative relief of anxiety and tension
Pharmacokinetics of benzos?
Well absorbed in the GI tract Metabolized in the liver Excreted in the urine Lipid soluble and well distributed throughout the body (extended period in body - build up) Cross placenta and enters breast milk
What are the contraindications and cautions of benzos?
Allergy, psychosis, acute narrow angle glaucoma, shock, coma, acute alcohol intoxication, pregnancy
In what type of patients are benzos not OK to give?
Patients with known illness or patients with head injury
Benzo side effects
Sedation Dry mouth
Drowsiness Constipation
Depression Nausea
Lethargy. Vomiting
Blurred vision. Hypotension
Confusion. Urinary retention
Benzos may cause peridoxical effects? True or false
True
Who is more sensitive to CNS drugs?
African Americans
What is the prototype for benzodiazepines?
Diazepam
What is the antagonist for diazepam?
Flumazenil given IV
Benzos cause anticholinergic effects?
True - dry eyes, dry mouth, constipation
It is important for the nurse to remove a patient from a benzo SLOWLY?
True
What are the actions of barbiturates?
CNS depression
Inhibit neuronal impulse conduction in the ascending RAS
Depress cerebral cortex
Depress motor output (lose coordination)
Cause: sedation, hypnosis, anesthesia, and coma
Barbiturates have more adverse effects and dependency that benzos?
True
What are the indications for barbiturates?
Relief of the signs and symptoms of anxiety Sedation Insomnia Pre-anesthesia Seizures
Pharmacokinetics of barbiturates
Well absorbed Metabolized in the liver Excreted in the urine Reaches peak in 20-60 minutes *KNOW LIVER & KIDNEY FUNCTION
Contraindication and cautions with barbiturates
Allergy
Previous history of addiction to sedative-hypnotic drugs
Metabolic dysfunction of ABCs
Marked hepatic impairment or nephritis
Respiratory distress or severe respiratory dysfunction
Pregnancy - crosses placenta and enters breast milk
Adverse effects of barbiturates
CNS depression. Vertigo
Physical dependency Nausea
Drowsiness. Vomiting
Somnolence Constipation
Lethargy
Ataxia ( walking )
Drug-Drug interactions with barbiturates
Alcohol, antihistamines, other tranquilizers
Phenytoin (seizure med)
Prototype for barbiturates
Phenobarbital (luminal)
