CNS depressants: chapter 13

Question 1

mechanism of action of benzodiazepines

Answer 1

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

Question 2

what receptors do benzodiazepines have an effect on

Answer 2

GABA receptors

Question 3

do benzodiazepines increase liver metabolism

Answer 3

no

Question 4

indications for nonbenzodiazepines

Answer 4

short term treatment of insomnia

Question 5

indications for benzodiazepines (5)

Answer 5

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

Question 6

2 contraindications for benzodiazepines

Answer 6

narrow angle glaucoma, pregnancy

Question 7

4 adverse effects of benzodiazepines

Answer 7

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

Question 8

4 symptoms of benzodiazepine toxicity

Answer 8

somnolence, confusion, coma, diminished reflexes

Question 9

what is the antidote for benzodiazepines

Answer 9

flumazenil

Question 10

which benzodiazepine is long acting

Answer 10

diazepam

Question 11

indication for diazepam (4)

Answer 11

anxiety, sedation, anticonvulsant therapy, skeletal muscle relaxation

Question 12

which benzodiazepine is intermediate acting

Answer 12

lorazepam

Question 13

2 indications for lorazepam

Answer 13

anxiety, acute seizure activity

Question 14

which benzodiazepine is short acting

Answer 14

midazolam

Question 15

indication for midazolam

Answer 15

preoperative and procedural sedation

Question 16

which drug is a nonbenzodiazepine

Answer 16

zopiclone

Question 17

is zopiclone long, intermediate, or short acting

Answer 17

short

Question 18

indication for zopiclone

Answer 18

short term treatment of insomnia

Question 19

why are barbiturates not commonly used

Answer 19

preference for benzodiazepines and low therapeutic index

Question 20

2 mechanisms of action of barbiturates

Answer 20

inhibit nerve impulse transmission, inhibit GABA

Question 21

2 effects of barbiturates

Answer 21

sedative, hyponotic

Question 22

3 contraindications for barbiturates

Answer 22

pregnancy, significant respiratory difficulties, severe kidney or liver disease

Question 23

3 adverse effects of barbiturates

Answer 23

vasodilation and hypotension if given rapidly, respiratory depression

Question 24

what does overdose of barbiturates cause

Answer 24

cns and respiratory depression

Question 25

what are the first signs of barbiturate overdose

Answer 25

cold, clammy skin or hypothermia

Question 26

what are the later signs of barbiturate overdose (3)

Answer 26

fever, tachycardia, hypotension

Question 27

what is the treatment for barbiturate overdose (5)

Answer 27

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

Question 28

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

Answer 28

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

Question 29

what drug is a barbiturate

Answer 29

phenobarbitol

Question 30

is phenobarbitol long, intermediate, or short acting

Answer 30

long

Question 31

3 indications for phenobarbitol

Answer 31

seizures, convulsions, hyperbilirubinemia in neontates

Question 32

3 OTC hypnotics

Answer 32

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

Question 33

what should not be used alongside OTC hypnotics. why

Answer 33

alcohol due to risk of respiratory depression or arrest

Question 34

what do muscle relaxants do to the cns

Answer 34

cause cns depression

Question 35

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

Answer 35

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

Question 36

mechanism of action of baclofen

Answer 36

depress nerve transmission in the spinal cord

Question 37

4 adverse effects of baclofen

Answer 37

lightheadedness, fatigue, confusion, muscle weakness

Question 38

treatment for baclofen overdose (4)

Answer 38

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

Question 39

indiction for baclofen

Answer 39

treat chronic spastic muscular conditions

Question 40

what is another muscle relaxant besides baclofen

Answer 40

cyclobenzaprine

Question 41

indication for cyclobenzaprine

Answer 41

reduce spasms after msk injuries

Question 42

how can you minimize gi upset when taking cns depressants

Answer 42

take with food

Question 43

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

Answer 43

rebound insomnia

Question 44

when is the chance of hypotension the greatest with muscle relaxants

Answer 44

within 1hr of dosing

Question 45

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

Answer 45

chance of anemia

Question 46

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

Answer 46

monitoring of therapeutic drug levels

Question 47

indications for kava (3)

Answer 47

relieve anxiety, stress, and restlessness

Question 48

3 adverse effects of kava

Answer 48

skin discolouration, papillary enlargement, scaly skin

Question 49

what risk does kava pose in terms of the liver

Answer 49

severe liver damage and toxicity

Question 50

6 contraindications for kava

Answer 50

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

Question 51

3 indications for valerian

Answer 51

relieve anxiety, restlessness, sleep disorders

Question 52

3 adverse effects of valerian

Answer 52

cns depression, hepatotoxicity, insomnia

Question 53

2 contraindications for valerian

Answer 53

heart and liver disease