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NURS 252 > CNS depressants: chapter 13 > Flashcards

CNS depressants: chapter 13 Flashcards

1
Q

mechanism of action of benzodiazepines

A

depress cns activity in the hypothalamic, thalamic, and limbic systems

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2
Q

what receptors do benzodiazepines have an effect on

A

GABA receptors

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3
Q

do benzodiazepines increase liver metabolism

A

no

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4
Q

indications for nonbenzodiazepines

A

short term treatment of insomnia

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5
Q

indications for benzodiazepines (5)

A

sedation, relieve anxiety, skeletal muscle relaxation, acute seizures disorders, symptoms of alcohol withdrawal

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6
Q

2 contraindications for benzodiazepines

A

narrow angle glaucoma, pregnancy

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7
Q

4 adverse effects of benzodiazepines

A

depressed cns, fall hazard, hangover effect, development of tolerance/dependance

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8
Q

4 symptoms of benzodiazepine toxicity

A

somnolence, confusion, coma, diminished reflexes

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9
Q

what is the antidote for benzodiazepines

A

flumazenil

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10
Q

which benzodiazepine is long acting

A

diazepam

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11
Q

indication for diazepam (4)

A

anxiety, sedation, anticonvulsant therapy, skeletal muscle relaxation

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12
Q

which benzodiazepine is intermediate acting

A

lorazepam

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13
Q

2 indications for lorazepam

A

anxiety, acute seizure activity

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14
Q

which benzodiazepine is short acting

A

midazolam

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15
Q

indication for midazolam

A

preoperative and procedural sedation

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16
Q

which drug is a nonbenzodiazepine

A

zopiclone

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17
Q

is zopiclone long, intermediate, or short acting

A

short

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18
Q

indication for zopiclone

A

short term treatment of insomnia

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19
Q

why are barbiturates not commonly used

A

preference for benzodiazepines and low therapeutic index

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20
Q

2 mechanisms of action of barbiturates

A

inhibit nerve impulse transmission, inhibit GABA

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21
Q

2 effects of barbiturates

A

sedative, hyponotic

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22
Q

3 contraindications for barbiturates

A

pregnancy, significant respiratory difficulties, severe kidney or liver disease

23
Q

3 adverse effects of barbiturates

A

vasodilation and hypotension if given rapidly, respiratory depression

24
Q

what does overdose of barbiturates cause

A

cns and respiratory depression

25
Q

what are the first signs of barbiturate overdose

A

cold, clammy skin or hypothermia

26
Q

what are the later signs of barbiturate overdose (3)

A

fever, tachycardia, hypotension

27
Q

what is the treatment for barbiturate overdose (5)

A

supportive measures such as ensuring airway, ventilation, and giving o2, fluids, and pressors

28
Q

what substance can be administered for barbiturate overdose (this is not an antidote). why is this substance administered

A

activated charcoal to draw drug molecules from circulation into the GI tract for elimination

29
Q

what drug is a barbiturate

A

phenobarbitol

30
Q

is phenobarbitol long, intermediate, or short acting

31
Q

3 indications for phenobarbitol

A

seizures, convulsions, hyperbilirubinemia in neontates

32
Q

3 OTC hypnotics

A

doxylamine, diphenhydramine hydrochloride (sleep-eze), acetaminophen/diphenhydramine hydrochloride (extra strength tylenol nighttime)

33
Q

what should not be used alongside OTC hypnotics. why

A

alcohol due to risk of respiratory depression or arrest

34
Q

what do muscle relaxants do to the cns

A

cause cns depression

35
Q

how does cns depression caused by muscle relaxants have an effect on the body (4)

A

relax skeletal muscles, cause mild weakness, decrease force of muscle contraction, reduce muscle stiffness

36
Q

mechanism of action of baclofen

A

depress nerve transmission in the spinal cord

37
Q

4 adverse effects of baclofen

A

lightheadedness, fatigue, confusion, muscle weakness

38
Q

treatment for baclofen overdose (4)

A

supportive measures such as gastric lavage, maintaining airway, ecg monitoring, and iv fluids

39
Q

indiction for baclofen

A

treat chronic spastic muscular conditions

40
Q

what is another muscle relaxant besides baclofen

A

cyclobenzaprine

41
Q

indication for cyclobenzaprine

A

reduce spasms after msk injuries

42
Q

how can you minimize gi upset when taking cns depressants

A

take with food

43
Q

what may occur 3-4 weeks after initiation of benzodiazepine therapy

A

rebound insomnia

44
Q

when is the chance of hypotension the greatest with muscle relaxants

A

within 1hr of dosing

45
Q

why must RBC count, hemoglobin, and hematocrit be monitored with barbiurates

A

chance of anemia

46
Q

what must be done when there is long term use of barbiturates

A

monitoring of therapeutic drug levels

47
Q

indications for kava (3)

A

relieve anxiety, stress, and restlessness

48
Q

3 adverse effects of kava

A

skin discolouration, papillary enlargement, scaly skin

49
Q

what risk does kava pose in terms of the liver

A

severe liver damage and toxicity

50
Q

6 contraindications for kava

A

parkinsons, liver disease, depression, alcoholism, pregnancy, breastfeeding

51
Q

3 indications for valerian

A

relieve anxiety, restlessness, sleep disorders

52
Q

3 adverse effects of valerian

A

cns depression, hepatotoxicity, insomnia

53
Q

2 contraindications for valerian

A

heart and liver disease

NURS 252 (18 decks)

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