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NCLEX > CNS Depressants and Muscle Relaxants > Flashcards

CNS Depressants and Muscle Relaxants Flashcards

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0
Q

Baclofen

Chemical Classification

A

GABA chlorophenyl derivative

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1
Q

Baclofen

Functional Classification

A

Skeletal Muscle Relaxant, Central Acting

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2
Q

Baclofen

Mechanism of Action

A

Inhibits synaptic responses in CNS by stimulating GABAb receptor subtype, which decreases neurotransmitter function; decreases frequency, severity of muscles spasms

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3
Q

Baclofen

Uses

A

Spasticity with spinal cord injury, multiple sclerosis

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4
Q

Baclofen

Contraindications

A

Hypersensitivity

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5
Q

Baclofen

Side Effects

A

CNS: Dizziness, Weakness, Fatigue, Drowsiness, headache, Disorientation, insomnia, paresthesias, tremors; SEIZURES, LIFE-THREATENING CNS DEPRESSION, COMA; CNS INFECTION (IT)
CV: hypotension, chest pain, palpitations, edema, CARDIOVASCULAR COLLAPSE (IT)
EENT: nasal congestion, blurred vision, mydriasis, tinnitus
GI: Nausea, constipation, Vomiting, increased AST, alk phos, abdominal pain, dry mouth, anorexia
GU: urinary frequency, hematuria
INTEG: rash, pruritus
RESP: dyspnea; respiratory failure (IT)

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6
Q

Baclofen

Nursing Considerations

A

ASSESS:

  • MULTIPLE SCLEROSIS: spasms, spasticity, ataxia; improvement should occur with product BP, weight, blood glucose, hepatic function periodically
  • SEIZURES: for increased seizure activity with seizure disorders; product decreases seizure threshold; EEG in epileptic patients
  • I&O ratio; check for urinary frequency
  • Allergic reactions: rash, fever, respiratory distress
  • Severe weakness, numbness in extremities
  • Tolerance: increased need for medication, more frequent requests for medication, increased pain
  • WITHDRAWAL SYMPTOMS: CNS depression, dizziness, drowsiness, psychiatric symptoms
  • INTRATHECAL: have emergency equipment nearby; assess test dose and titration; if no response, check pump, catheter for proper function

PERFORM/PROVIDE:
-Assistance with ambulation if dizziness, drowsiness occurs

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7
Q

Baclofen

Overdose Treatment

A

Induce emesis of conscious patient, activated charcoal, dialysis, physostigmine to reduce life-threatening CNS side effects

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8
Q

Cyclobenzaprine

Functional Classification

A

Skeletal muscle relaxant, central acting

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9
Q

Cyclobenzaprine

Chemical Classification

A

Tricyclic Amine Salt

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10
Q

Cyclobenzaprine

Mechanism of Action

A

Reduces tonic muscle activity at the brain stem; may be related to antidepressant effects

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11
Q

Cyclobenzaprine

Uses

A

Adjunct for relief of muscle spasm and pain in musculoskeletal conditions

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12
Q

Cyclobenzaprine

Contraindications

A

Children <12yr, acute recovery phase of MI, dysrhythmias, heart block, CHF, hypersensitivity, intermittent porphyria, thyroid disease, QT prolongation

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13
Q

Cyclobenzaprine

Side Effects

A

CNS: Dizziness, Weakness, Drowsiness, headache, tremor, depression, insomnia, confusion, paresthesia, nervousness
CV: postural hypotension, tachycardia, DYSRHYTHMIAS
EENT: diplopia, temporary loss of vision
GI: Nausea, vomiting, hiccups, dry mouth, constipation, hepatitis
GU: urinary retention, frequency, change in libido
INTEG: rash, pruritus, fever, facial flushing, sweating

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14
Q

Cyclobenzaprine

Nursing Considerations

A

ASSESS:

  • PAIN: location, duration, mobility, stiffness at baseline, periodically
  • ALLERGIC REACTIONS: rash, fever, respiratory distress
  • severe weakness, numbness in extremities

PERFORM/PROVIDE:
-Assistance with ambulation if dizziness, drowsiness occur, especially for geriatric patients

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15
Q

Cyclobenzaprine

Overdose Treatment

A

Administer activated charcoal; use anticonvulsants if indicated; monitor cardiac function

16
Q

Temazepam

Functional Classification

A

Sedative/Hypnotic

17
Q

Temazepam

Chemical Classification

A

Benzodiazepine, short to intermediate acting

18
Q

Temazepam

Mechanism of Action

A

Produces CNS depression at limbic, thalamic, hypothalamic levels of the CNS; may be mediated by neurotransmitter gamma aminobutyric acid (GABA); results are sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, anxiolytic action

19
Q

Temazepam

Uses

A

Insomnia

20
Q

Temazepam

Contraindications

A

Pregnancy (X), breastfeeding, hypersensitivity to benzodiazepines, intermittent porphyria

21
Q

Temazepam

Side Effects

A

CNS: Lethargy, Drowsiness, Daytime Sedation, dizziness, confusion, light-headedness, headache, anxiety, irritability, complex sleep-related reactions (sleep-driving, sleep eating), fatigue
CV: chest pain, pulse changes, hypotension
EENT: blurred vision
GI: nausea, vomiting, diarrhea, heartburn, abdominal pain, constipation, anorexia
SYST: SEVERE ALLERGIC REACTIONS

22
Q

Temazepam

Nursing Considerations

A

ASSESS:

  • Mental status: mood, sensorium, affect, memory (long, short)
  • Type of sleep problem: falling asleep, staying asleep
  • DEPENDENCY: restrict amount given to patient, assess for physical/psychological dependency; high-level risk for abuse

PERFORM/PROVIDE:

  • Assistance with ambulation after receiving dose
  • Safety measures: night-light, call bell within easy reach
  • Checking to confirm that PO medication has been swallowed
23
Q

Temazepam

Overdose Treatment

A

Lavage, activated charcoal; monitor electrolytes, VS

24
Q

Zaleplon

Functional Classification

A

Sedative/Hypnotic, Nonbarbiturate

25
Q

Zaleplon

Chemical Classification

A

Pyrazolpyrimidine

26
Q

Zaleplon

Mechanism of Action

A

Binds selectively to omega-1 receptor of the GABA(A) receptor complex; results are sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, anxiolytic action

27
Q

Zaleplon

Uses

A

Insomnia

28
Q

Zaleplon

Contraindications

A

Hypersensitivity, Severe Hepatic Disease

29
Q

Zaleplon

Side Effects

A

CNS: Lethargy, Drowsiness, Daytime Sedation, dizziness, confusion, anxiety, amnesia, depersonalization, hallucinations, hyperesthesia, paresthesia, somnolence, tremor, vertigo, complex sleep related reactions: sleep driving, sleep eating
EENT: vision change, ear/eye pain, hyperacusis, parosmia
GI: nausea, abdominal pain, constipation, anorexia, colitis, dyspepsia, dry mouth
MISC: asthenia, fever, headache, myalgia, dysmenorrhea
SYST: SEVERE ALLERGIC REACTIONS

30
Q

Zaleplon

Nursing Considerations

A

ASSESS:

  • Mental Status: mood, sensorium, affect, memory (long, short term) excessive sedation, impaired coordination
  • SLEEP DISORDER: type of sleep problem: falling asleep, staying asleep

PERFORM/PROVIDE:

  • Assistance with ambulation
  • Safety measure: night-light, call bell within easy reach
  • Check to see if PO medication has been swallowed
31
Q

Zolpidem (Ambien)

Functional Classification

A

Sedative/Hypnotic

32
Q

Zolpidem (Ambien)

Chemical Classification

A

Imidazopyridine

33
Q

Zolpidem (Ambien)

Mechanism of Action

A

Produces CNS depression at limbic, thalamic, hypothalamic levels of CNS; may be mediated by neurotransmitter gamma aminobutyric acid (GABA); results are sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activitym anxiolytic action

34
Q

Zolpidem (Ambien)

Uses

A

Insomnia, short-term treatment; insomnia with difficulty of sleep onselt/maintenance (ext rel)

35
Q

Zolpidem (Ambien)

Contraindications

A

Hypersensitivity to benzodiazepines

36
Q

Zolpidem (Ambien)

Side Effects

A

CNS: headache, lethargy, drowsiness, daytime sedation, dizziness, confusion, lightheadedness, anxiety, irritability, amnesia, poor coordination, complex sleep-related reactions (sleep driving, sleep eating), depression, somnolence, SUICIDAL IDEATION, abnormal thinking/behavior changes
CV: chest pain, palpitations
GI: nausea, vomiting, diarrhea, heartburn, abdominal pain, constipation
HEMA: LEUKOPENIA, GRANULOCYTOPENIA (rare)
MISC: myalgia
SYST: SEVERE ALLERGIC REACTIONS

37
Q

Zolpidem (Ambiem)

Nursing Considerations

A

ASSESS:

  • Mental Status: mood, sensorium, affect, memory (long, short term), excessive sedation, impaired coordination, SUICIDAL THOUGHTS/BEHAVIORS
  • Blood dyscrasias: fever, sore, throat, bruising, rash, jaundice, epistaxis (rare)
  • Type of sleep problem: falling asleep, staying asleep

PERFORM/PROVIDE:
-Assistance with ambulation after receiving dose

38
Q

Zolpidem (Ambien)

Overdose Treatment

A

Lavage, activated charcoal; monitor electrolytes, VS

NCLEX (40 decks)

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