CNS depressants,CNS stimulants, anti-seizure Drugs

Question 1

what are the 4 stages of non-REM sleep?

Answer 1

stage 1: dozing 2-5% of normal sleep BUT those with insomnia have longer stage 1

stage 2: relaxed but person can easily be awakened (50% of sleep)

stage 3: deep sleep - BP, HR may decrease (5 % of sleep)

stage 4: difficult to wake - dreaming occurs in this stage. (10-15% of sleep)

Question 2

What is REM sleep?

Answer 2

when vivid dreams occur and irregular breathing

Question 3

why is the use of benzodiazepines long term contraindicated?

Answer 3

may have a similar effect on the brain as alcohol and can cause dependancy so its best not to use long term but short term

Question 4

what can patients face with benzodiazepines?

Answer 4

hangover effect in the morning and rebound insomnia

Question 5

what neurotransmitter do benzodiazepines increase and why ?

Answer 5

benzodiazepines increase GABA which is an inhibitory neurotransmitter. GABA calms the CNS and reduces the firing of neurone so you can sleep better and be calm

Question 6

what is the relationship between zopiclone and benzos?

Answer 6

they used to think zopiclone is safer than benzos but it was found that zopiclone might actually be more addictive.

Question 7

why is longterm use of muscle relaxant contraindicated?

Answer 7

increase tolerance and dependency

Question 8

where so muscle relaxants work on?

Answer 8

It is believed that the muscle relaxant effects are a result of this CNS depressant activity.

Question 9

which muscle relaxant actually works on the skeletal muscle?

Answer 9

dantrolene. It belongs to a group of relaxants known as direct acting skeletal muscle relaxants and closely resembles GABA

Question 10

how does dantrolene work?

Answer 10

it directly affects skeletal muscles by decreasing the response of the muscle to stimuli. it does this by decreasing the amount of calcium released from the muscles storage

Question 11

how do the other muscle relaxant work?

Answer 11

By CNS depression specifically at the brainstem and enhances GABA’s inhibitory effects at the level os the spinal cord.

Question 12

in terms of GABA in most muscle relaxants, what about Baclofen? And why is it the most effect drug in this class

Answer 12

Baclofen is one of the more effective drugs in this class and is a derivative of GABA. It is believed to work by depressing nerve transmission in the spinal cord.

Question 13

when are muscle relaxants best effective?

Answer 13

when used in conjunction with rest and physiotherapy.

Question 14

how does dantrolene work?

Answer 14

it directly affects skeletal muscles by decreasing the response of the muscle to stimuli. it does this by decreasing the amount of calcium released from the muscles storage to help decrease contraction

Question 15

what is the main side effects of muscle relaxants?

Answer 15

they cause sedation and drowsiness! also cirrhosis

Question 16

what is the main pt teaching for muscle relaxants?

Answer 16

pt should NOT abruptly stop taking this medication as it can cause a rebound effect

Question 17

summarize the 3 muscle relaxant drugs

Answer 17

1) cyclobenzaprine
2) baclofen
3) dantrolene

Question 18

why not use muscle relaxants and benzos long term?

Answer 18

double AA. abuseand addiction

Question 19

what are CNS stimulants?

Answer 19

increase excitatory neurotransmitters in the brain. basically you will have lots of energy and alertness, decrease appetite and enhance task performance by reducing fatigue

these neurotransmitters are:
1) dopamine
2) serotonin
3) norepinephrine

Question 20

how do amphetamines and phenidates work?

Answer 20

Amphetamines stimulate areas of the brain associated with mental alertness.

The amphetamines and phenidates increase the effects of norepinephrine and dopamine in CNS synapses by increasing their release and blocking their reuptake. As a result, both neu- rotransmitters are in contact with their receptors longer, which lengthens their duration of action.

Question 21

CNS stimulants are first line defence for which 2 conditions?

Answer 21

1) ADHD
2) narcolepsy

Question 22

what is a drug holiday?

Answer 22

usually once per week in order to decrease chance of becoming addicted to them.

Often, school-aged children taking these drugs do not take them on weekends or during school vacations.

Question 23

when should stimulants not be used?

Answer 23

when taking MOAI and glaucoma

Question 24

what is the side effects of stimulants?

Answer 24

everything in the body is sped up; metabolism, BP, HR etc..

Question 25

what is orlistat?

Answer 25

basically it isn’t a CNS stimulant but works by irreversibly inhibiting the enzyme lipase. This results in reduced absorption of dietary fat from the intestinal tract and increased fat elimination in the feces.

Question 26

what should the nurse teach about orlistat?

Answer 26

Decreases in serum concentrations of vitamins A, D, and E and beta carotene are seen as a result of the blocking of fat absorption. Supplementation with fat-soluble vitamins corrects this deficiency.

Question 27

ephedrine for weightless?

Question 28

how do triptans work?

Answer 28

first line therapy for migraines. They work by stimulating serotonin receptors (5-HT) causing vasoconstriction and normally reducing or eliminating headache symptoms. They also reduce the production of inflammatory neuropeptides.

Question 29

what should the nurse monitor before giving triptans?

Answer 29

cardiovascular system assessment

Question 30

why would a migraine be worse even if medication is take but the patient doesnt have their morning coffee?

Answer 30

caffeine reduces cerebral blood flow which helps with vasoconstriction. caffeine does not relieve pain by itself but can enhance the triptan action in the brain to relive the migraine with great results.

Question 31

what do anti-epileptic medications do?

Answer 31

works in 3 ways:

1) increasing the threshold of cells in the motor cortex which makes them less excitable

2) suppress transmission of impulses between neurons

3) decrease speed of transmission

Question 32

what are the first line drugs for epilepsy?

Answer 32

1) barbiturates

2) hydantoins

3) iminostilbenes

4) adjunct

Generalized Mechanism is to increase the amount of GABA because low levels of GABA are associated with seizures.

Question 33

what is a side effect of anti-epileptic drugs?

Answer 33

skin rashes and immune reactions are big side effects

Question 34

should anti-epileptic drugs be mixed with other meds?

Answer 34

no because it reduces its effect and some can even be fatal (alcohol)

Question 35

can you use anti-epileptic meds with anitfungals?

Answer 35

no it reduces hydantoin clearance and increased effects