Chapter 20 Flashcards
Benzodiazepines: Actions & Indications
Lower doses assist with anxiety
Higher doses cause sedation and hypnosis
Indications: anxiety disorders, alcohol withdrawal, hyperexcitability and agitation, preoperative relief of anxiety and tension to aid in balanced anesthesia
NOT RECOMMENDED FOR LONG TERM USE***
Benzodiazepines: Pharmacokinetics
Well absorbed from GI tracts
Peak levels achieved in 30 minutes to 2 hours
Can cross placenta and enter breast milk
Metabolized in liver, excreted primarily in urine
Highly Addictive (Schedule IV)
Benzodiazepines: Contraindications & Cautions
Allergies
Psychosis
Acute narrow angle glaucoma (can increase pressure)
Coma/Shock
Acute alcohol withdrawal
Pregnancy
Benzodiazepines: RN Assessments & Considerations
Vitals Signs: BP, respiration’s, HR, SpO2, EKG
LOC, pupils, extremity strength, mental status
Quality/depth of respiration’s
Benzodiazepines: Adverse Effects
Sedation, drowsiness, CNS depression, depression, lethargy, confusion, nausea, vomiting, hypotension
Blurred vision, dry mouth, constipation, urinary retention
These effects can also be from withdrawal if medication is not tapered
Benzodiazepines: Generic Drug Names
Alprazolam
Clonazepam
Diazepam
Lorazepam
Oxazepam
Benzodiazepines: Drug to Drug Interactions
Increases CNS depression when taken with alcohol
Decrease in effect if given with theophylline or ranitidine
Barbiturates: Actions & Indications
Actions: CNS depressants, depress cerebral cortex and motor output, causes sedation, hypnosis, anesthesia and coma
Indications: relief of signs and symptoms of anxiety, sedation, insomnia, preanesthesia, seizures
Benzodiazepines: Generic Drug Names
Phenobarbital
Secobarbital
Benzodiazepines: Pharmacokinetics
Well absorbed, reaches peak in 20-60 minutes, metabolized in the liver, excreted in the urine
Benzodiazepines: Contraindications & Cautions
Allergies, history of addiction to sedative/hypnotic drugs, liver or kidney impairment, respiratory distress or dysfunction, pregnancy
NOT RECOMMENDED FOR LONG TERM USE
Benzodiazepines: Adverse Effects
CNS depression, physical dependency, drowsiness, somnolence, lethargy, ataxia, vertigo, nausea, vomiting, constipation
Benzodiazepines: Drug to Drug Interactions
Increases CNS depression when taken with alcohol
Altered response to phenytoin
MAO causes increase serum levels and effect
Decreases effectiveness of the following drugs: anticoagulants, digoxin, tricyclic antidepressants, corticosteroids, oral contraceptives
Promethazine & Diphenhydramine
What are these and their best use for
Antihistamines
Pre and Post Op to decrease need for narcotics
Want the patient awake but drowsy
Buspirone
What are these and their best use for
Anxiolytic
Reduces signs and symptoms of anxiety without severe CNS depression and adverse effects, if you don’t want the patient to have sedation and muscle relaxation (not as effective as benzo’s)
