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Medication Cards > CNS Depressants and Muscle Relaxants > Flashcards

CNS Depressants and Muscle Relaxants Flashcards

1
Q

Sedatives

A
  • inhibitory effect on the CNS
  • reduce nervousness
  • excitability
  • irritability
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2
Q

Hypnotics

A
  • cause sleep
  • more poteint effect on CNS than sedatives
  • sedative can become a hypnotic if given in large enough dosages
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3
Q

CNS depressants

A
  1. barbiturates
  2. benzodiazepines
  3. miscellaneous
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4
Q
  1. benzodiazepines
A
  • formerly most commonly prescribed
  • non-benzos are more commonly prescribed due to high addiction rates
  • classified as either sedative-hypnotic or anxiolytic
  • depress CNS activity
  • dont supress REM sleep as much as barbiturates fo
  • dont increase metabolism of other drugs
  • control agitation and anxiety, msk relaxtion and sensory stimuli
  • acute sezuire disorder
  • alcohol withdrawl
  • insomnia
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5
Q

Sedative- Hypnotic Benzo

A

long acting
* diazepam (valium)
intermediate acting
* lorazepam (ativan)
short acting
midazolam hydrochloride

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6
Q

Adverse Effects of Benzos

A

headache
drowiness
paradoxical excitement
dizziness
cognitive impariment
vertigo
lethargy
fall hazard
hangover effect or day time sleepiness

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7
Q

Benzo Overdose

A
  • flumazenil is the antidote
  • confusion, flush skin, coma
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8
Q

Benzo Interactions

A
  • azole antifungals, verapamil, diltiazem, protease inhibitors, macrolide antibiotics grapefruit juice
  • CNS depressants
  • Kava and valerian
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9
Q

Diazepam (valium)

A
  • long acting benzo
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10
Q

Midazolam

A

short acting benzo
used pre op and procedural for sedation
causes amnesia and anxiolysis and sedation
IV in adults
liquid oral dosage form is available for children

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11
Q

Lorazepam (ativan)

A
  • intermediate- acting
  • used to treat anxiety
  • induces sleep within 30-60 min
  • long onset of action, take 1hr before going to bed
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12
Q

Nonbenzo: Zopiclone (imovane, rhovane)

A
  • short acting benzo like drug
  • very short half life
  • short term treatmemt of insomnia 7-10 days
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13
Q

Herbal Products Kava

A
  • relieve anxiety, stress and restlrssness to promote sleep
  • may cause temporary skin discoloration, scaly skin and visual disturbances
  • interacts with alcohol, barbiturates and psychoactive drugs
  • contraindicated in liver disease, alcoholism
  • dont operate heavy machinery during use
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14
Q

Herbal Products Valerian

A
  • relieve anxiety, restlessness and sleep disorders
  • may cause CNS depression, hepatotoxicity, nausea, vomiting, anorexia, headache, restlessness, insomnia
  • interacts with CNS depressants, MAOI, phenytoin, warfarin and alcohol
  • contraindicated in cardiac and liver disease
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15
Q

Barbiturates

A
  • older drug
    *benzos are more commonly used
  • MOA: potentiating the action of GABA, nerve impulses travelling in the cerebral cortex are inhibited
  • sedatives, anticonvulsants, anaesthesia
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16
Q
A
16
Q

Adverse Effects Barbiturates

A
  • vasodilation, hypotension
  • resp depression, cough
  • agranulocytosis, **thrombocytopenia **
  • stevens-johnson syndrom

**Contraindications:
pregancy
severe COPD
liver diasease
use of opiod **

17
Q

Barbiturates Overdose

A
  • rarely used
  • overdose leads to resp depression and subsequent resp arrest
  • coma and death
  • activated charchol
  • pentobarbital in canada
18
Q

Barbiturates Interactions

A
  • alcohol, antihistamines, benzo, opioids, tranquilzers
  • Inhibited metabolism of MAOI
  • increased metabolism of anticogulant, leading to clot formation as it reduces there affect
19
Q

Doxylamine succinate (unisom-2), diphenhydramine hydrochloride (sleep- eze) and acetaminophen/ diphenhydramine (extra strength tyenol night time)

A
  • non- prescription sleeping aids, have CNS depressants (antihistamines)
19
Q

Phenobarbital

A
  • protypical barbiturate
  • long acting
  • prevntion of tonic-clonic sezures and fever induced convulsions
  • treatment of hyperbillirubinemia in neonates
  • rarley used today as a sedative and no longer recommeneded as a hypnotic
19
Q

Baclofen (Lioresal)

A

relaxing your muscles, which reduces muscle stiffness

20
Q

Muscle Relaxants

A

adverse effects: euphoria, light headed, dizzy, drowsy, fatigue, confusion, muscle weakeness

21
Q

Cyclobenzaprine hydrochloride (novo-cycloprine)

A

A centrally acting skeletal muscle relaxant, it is used in the symptomatic treatment of painful muscle spasm. It has a role as a muscle relaxant and an antidepressan

22
Q

Nursing Considerations

A
  • administer hypnotics 30-60 min before bed
  • most benzo cause REM sleep interferance adn a tired next day feeling the next day, use with caution in older adults
  • avoid alcohol and other CNS depressants
  • rebound insomnia may occue for a few nights after a 3-4 week regimen has been discontinued
  • consider saftey aspects for fall risk

Medication Cards (3 decks)

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