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Pharmacology II > Central Nervous System Depressants and Muscle Relaxants > Flashcards

Central Nervous System Depressants and Muscle Relaxants Flashcards

1
Q

What is a sedative?

A

A drug that has the ability to inhibit the CNS causing reduced:
Nervousness
Excitability
Irritability

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2
Q

What are hypnotics?

A

Drugs that cause sleep

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3
Q

T/F: Hypnotics are less potent than seditives

A

F: Hypnotics are more potent than sedatives

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4
Q

Which drug can become a hypnotic if given in large doses?

A

Sedatives

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5
Q

What are the three groups of CNS depressants?

A

Barbiturates
Benzodiazepines
Miscellaneous drugs

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6
Q

What is more commonly prescribed Benzodiazepines or Nonbenzodiazepines? Why?

A

Nonbenzodiazepines due to favorable AEs, efficacy, and safety

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7
Q

What are the three types of Benzodiazepines? Which drugs are in these categories?

A

Long acting: Diazepam
Intermediate acting: Lorazepam
Short acting Midazolam Hydrochloride

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8
Q

What is the MOA of Benzodiazepines?

A

They depress the CNS, by interfering in the hypothalamic, thalamic, and limbic regions of the brain as well influence GABA receptors

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9
Q

What effect do Benzodiazepines have on the body?

A

They calm the CNS
used for agitation and anxiety
Reduce sensory stimuli = sleep
induce skeletal muscle relaxation

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10
Q

What are Benzodiazepines indicated for? Examples?

A

Sedation (short term insomnia therapy)
Sleep induction
Skeletal muscle relaxation (seizures)
Agitation or anxiety relief (Alcohol withdrawal)
Anxiety-related depression

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11
Q

What are the AEs of Benzodiazepines?

A

Mild and infrequent
Headache
Drowsiness
Paradoxical excitement of nervousness
Dizziness
Cognitive impairment
Vertigo
Lethargy
Fall hazard for older adults
“Hangover” effect or daytime sleepiness

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12
Q

What are the S&S of Benzodiazepines Toxicity and OD?

A

Somnolence (strong sleepy feeling)
Confusion
Coma
Diminished reflexes

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13
Q

What is the antidote for Benzodiazepines OD?

A

Flumazenil

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14
Q

What consumables do Benzodiazepines interact with?

A

CNS depressants (alcohol, opioids, muscle relaxants)
grapefruit and grapefruit juice

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15
Q

What drugs do Benzodiazepines interact with?

A

Azole antifungals, verapamil, diltiazem, protease inhibitors, macrolide antibiotics
Kava and valerian

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16
Q

What was the first available benzodiazepine drug?

A

Diazepam

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17
Q

What sedative is commonly used preop and during the procedure?

A

Midazolam

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18
Q

What route can Midazolam be adminstred?

A

Normally IV (adults), liquid oral (children)

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19
Q

What dose Midazolam cause?

A

Reduces anxiety and sedation

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20
Q

When should a pt take Lorazepam before going to bed?

A

1 hour before due to long OSA

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21
Q

What type of benzodiazepinelike drug is zopiclone?

A

Short acting

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22
Q

What is Kava?

A

A herbal product used to relive anxiety, stress, restlessness, and help sleep

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23
Q

What are some AEs of Kava?

A

yellow skin discoloration, scaly skin, vision changes

24
Q

What dose Kava interact with?

A

alcohol, barbiturates, and psychoactive drugs

25
Q

What is Kava contraindicated for?

A

liver disease, alcoholism, operating heavy machinery

26
Q

What is Valerian?

A

A drug used to relive anxiety, restlessness, sleep disorder

27
Q

What are some AEs of Valerian?

A

CNS depression, hepatotoxicity, nausea, vomiting, anorexia, headache, restlessness, insomnia

28
Q

What dose Valerian interact with?

A

CNS depressants, monoamine oxidase inhibitors (MAOIs), phenytoin, warfarin, and alcohol

29
Q

What is Valerian contraindicated for?

A

Cardiac and liver disease, operating heavy machinery

30
Q

What is the MOA of Barbiturates?

A

Work in the reticular formation (brain stem) to inhibit GABA nerve impulses in the Cerebral cortex

31
Q

What are the indications of Barbiturates?

A

Sedatives
Anticonvulsants
Anaesthesia for surgical procedures

32
Q

What are the AEs of Barbiturates?

A

Cardiovascular: Vasodilation, hypotension
CNS: Drowsiness, lethargy, vertigo
Respiratory: Respiratory depression, cough
Gastrointestinal: Nausea, vomiting, diarrhea, constipation
Hematological: Agranulocytosis, thrombocytopenia
Other: Hypersensitivity reactions, Stevens-Johnson syndrome

33
Q

What is the common use of Barbiturates in Canada?

A

Anesthesia induction’
Uncontrollable seizures
Coma (Phenobarbital)

34
Q

What should be done for a Barbiturate OD?

A

Maintain adequate airway
Assisted ventilation or oxygen therapy
Fluids
Alkalization
Activated charcoal

35
Q

What drugs have an additive effect on Barditurates?

A

Alcohol, antihistamines, benzodiazepines, opioids, tranquilizers

36
Q

What substances inhibit metabolism of Barbiturates?

A

MAOIs prolong the effects of barbiturates

37
Q

What substances increase the metabolism of barbiturates?

A

Reduces anticoagulant response, leading to possible clot formation

38
Q

What is the Barbiturate drug you need to know for the exam?

A

phenobarbital

39
Q

What is Phenobarbital used for?

A

Seizure prevention
prevent hyperbilirubinemia in neonates
rarely used as a sedative

40
Q

What are some OTC hypnotics?

A

Doxylamine succinate
diphenhydramine hydrochloride
acetaminophen/diphenhydramine

41
Q

When CNS depressants are combined with ____ it can cause respiratory depression/arrest

A

Alcohol

42
Q

What is the purpose of Muscle relaxants?

A

relive pain relating to muscle spasms

43
Q

Where do most Muscle relaxants work in the body?

A

CNS

44
Q

What do Muscle relaxants act on?

A

Skeletal muscles

45
Q

What are the indications of Muscle relaxants?

A

Relief of painful muscle spasms
(MS, cerebral palsy)

46
Q

Muscle relaxants work best when combined with what?

A

Physical therapy

47
Q

What are the AEs of Muscle relaxants?

A

Euphoria
Lightheadedness
Dizziness
Drowsiness
Fatigue
Confusion
Muscle weakness, others

48
Q

What are the Muscle relaxant drugs you need to know for the exam?

A

Baclofen
Cyclobenzaprine HCl

49
Q

What needs to be obtained before admin of Central Nervous System Depressants and Muscle Relaxants?

A

HH
Allergies
med hx
VS (supine and standing BP)
I/O
contraindications/ drug intx

50
Q

When should hypnotics be administered for max effect?

A

30-60 mins before bed

51
Q

What do most benzodiazepines cause?

A

REM interference and a tired feeling the next day; use with caution in older adults.

52
Q

What should patients taking Central Nervous System Depressants and Muscle Relaxants drugs avoid?

A

Alcohol

53
Q

T/F: Rebound insomnia may occur after 3-4 week regime has been stoped?

A

T

54
Q

What safety considerations must the nurse take when patient is taking Central Nervous System Depressants and Muscle Relaxants?

A

Keep side rails up or use bed alarms.
Do not permit smoking.
Assist patients (especially older adults) with ambulation .
Keep call light within reach
monitor for AEs

55
Q

What are the signs that the drug is working?

A

Increased ability to sleep at night
Fewer awakenings
Shorter sleep-induction time
Few adverse effects, such as “hangover” effects
Improved sense of well-being because of improved sleep
For muscle relaxants: decreased spasticity, decreased rigidity, pain relief

56
Q

What is the max dose of Lorazepam per day?

A

4 mg

57
Q
A

Pharmacology II (12 decks)

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