CNS Stimulants

Question 1

what are sedatives

Answer 1

Drugs that have an inhibitory effect on the central nervous system (CNS) to the degree that they reduce:
Nervousness
Excitability
Irritability

Question 2

what are hypnotics?

Answer 2

they can cause sleep
and are more potent than sedatives

Question 3

can you give a hypnotic in large quantities and cause sedative effect

Answer 3

yes

Question 4

what are the three classes of sedatives?

Answer 4

Barbiturates
Benzodiazepines
Miscellaneous drugs

Question 5

what is sleep?

Answer 5

a normal and cyclical and repetitive cycle

Question 6

True or false: benzodiazepines were used to be given as sedative-hypnotic dugs?

Answer 6

true

Question 7

what can benzodiazepines be also classed as?

Answer 7

sedative-hypnotic or anxiolytic

Question 8

what is a long acting benzodiazepine?

Answer 8

diazepam

Question 9

what is an intermediate acting Benz.?

Answer 9

lorazepam

Question 10

what is a short acting Benz.?

Answer 10

mdiazolam hcl

Question 11

what are the effects of benzodiazepines?

Answer 11

calm the CNS, muscle skeletal relaxation, induce sleep

Question 12

when should u use benzodiazepines?

Answer 12

sleep, sedation, skeletal muscle relaxation, agitation, anxiety related depression, acute seizure disorders, alcohol withdrawal, insomnia

Question 13

what are some adverse effects of benzo.?

Answer 13

headache, drowsiness, reverse excitement, cognitive impairment, fall hazard, hangover effect

Question 14

how can we categorize toxicity and overdose?

Answer 14

somnolence (sleepiness)
confusion
coma
diminished relfexes
rarely hypotension, or res depression (unless taken with CNS depressants)

Question 15

what is a treatment for benzodiazepine overdose?

Answer 15

flumenazil

Question 16

what are some interactions for benzodiazepines?

Answer 16

“zole” antifungals, verapamil, dilitiazem, protease inhibitor, grapefruit juice
Kava and valerian

Question 17

what was the first clinically available benzodiazepine drug, and also to treat anxiety?

Answer 17

diazepam

Question 18

what benzodiazepine is used for preoperatively and procedural sedation?

Answer 18

midazolam

Question 19

what are some adverse effects of midazolam?

Answer 19

amnesia and anxiolysis, sedation
This drug is given mostly through IV and liquid oral dosage

Question 20

what is an intermediate acting benzodiazepine that induces sleep within 30-60 mins?

Answer 20

lorazepam

Question 21

when should patients take lorazepam if they need to sleep?

Answer 21

1 hour prior

Question 22

tell me about zopiclone? (3 points)

Answer 22

short acting Benz.
short half-life
used for insomnia, for 7-10 days

Question 23

what is kava?

Answer 23

promote sleep, relieve anxiety, stress, and restless
can cause yellowing, scaly skin, visual disturbances

Question 24

what are some interactions of kava?

Answer 24

alcohol, barbiturates, and psychoactive drugs

Question 25

what are some contraindications for kava?

Answer 25

liver disease, alcoholism

Question 26

what is an important teaching for patients taking kava?

Answer 26

not to operate heavy machinery

Question 27

what is valerian?

Answer 27

used to receive anxiety, restless, and sleep. Can cause CNS depression, nausea, hepatoxicty, insomnia.

Question 28

what are some interactions of valerian?

Answer 28

CNS depressants, MOA, phenytoin, warfarin, and alcohol

Question 29

what are contraindications of valerian?

Answer 29

cardiac and liver disease

Question 30

what should you teach patients taking valerian?

Answer 30

not to operate heavy machinery when using

Question 31

why did we stop using barbiturates?

Answer 31

they cause a habit, and have low-therapeutic index

Question 32

what are some indications for barbiturates?

Answer 32

sedatives, anticonvulsants

Question 33

what is phenobarbital used for?

Answer 33

for coma

Question 34

what are some treatments for overdose pf barbiturates?

Answer 34

symptomatic and supportive
maintain adequate airway
assisted ventilation or oxygen therapy
fluids
alkalization
activated charcoal

Question 35

what can give an additive effect when using barbitureates?

Answer 35

Alcohol, antihistamines, benzodiazepines, opioids, tranquilizers

Question 36

what can give inhibited metabolism when taking barbiturates?

Answer 36

MAOIs prolong the effects of barbiturates

Question 37

what can give increase metabolism when taking barbiturates?

Answer 37

Reduces anticoagulant response, leading to possible clot formation

Question 38

what is a common barbiturates

Answer 38

phenobarbital

Question 39

why do you use phenobarbital?

Answer 39

prevention of generalized tonic-clonic seizure, fever-induced convulsion

Question 40

what are some over counter hypnotics

Answer 40

Doxylamine succinate (Unisom-2®), diphenhydramine hydrochloride (Sleep-Eze®), acetaminophen/diphenhydramine (Extra Strength Tylenol® Nighttime) – know names

Question 41

when would you use muscle relaxants

Answer 41

Muscle spasms
Management of spasticity of severe chronic disorders (multiple sclerosis, cerebral palsy)
Work best when used along with physical therapy

Question 42

what are some adverse effects of muscle relaxants

Answer 42

Euphoria
Lightheadedness
Dizziness
Drowsiness
Fatigue
Confusion
Muscle weakness, others

Question 43

what are some common muscle relaxants

Answer 43

baclofen
cyclobenzaprine hcl

Question 44

when should you administer hypnotics to have an effective sleep

Answer 44

30-60 mins

Question 45

when does round insomnia usually start after regimen

Answer 45

3-4 week