CNS stimulants and depressants Flashcards
CNS stimulants
ADHD
narcolepsy
reversal of respiratory distress
Three categories of CNS stimulants
amphetamines (acts on cerebral cortex)
analeptics/ caffeine (acts on brainstem and medulla)
anorexiants (act on satiety center in hypothalamic and limbic areas)
ADHD patho
dysregulation of transmitters
ADHD epidemiology
usually occurs before 7
more common in males/ boys
ADHD characteristics
inattentiveness
inability to concentrate
restlessness
hyperactivity
impulsivity
inability to complete tasks
narcolepsy
recurrent attacks of drowsiness and sleep during normal walking activities
falling asleep while
driving
talking
eating
standing
amphetamine action
stimulate release of norepi and dopamine
inhibit reuptake of norepi and dopamine
High potential for abuse
amphetamine side effects
tachycardia
palpitations
hypertension
restlessness
irritability
blurred vision
insomnia
dry mouth
anorexia
ED
amphetamine-like drugs for ADHD
Methylphenidate (Ritalin)
dexmethylphenidate (Focalin)
increase attention span and performance
decrease hyperactivity and impulses
amphetamine-like drugs for narcolepsy
methylphenidate (Ritalin)
modafinil (Provigil)
increase wakefulness
Methylphenidate action
Ritalin
modulates serotonergic pathways by affecting changes in dopamine transport
ADHD
narcolepsy
methylphenidate interactions
caffeine increases effects
may decrease antihypertensives
increase effects of oral anticoags, anticonvulsants, MAOIs, and tricyclic
may alter insulin effects
Methylphenidate side effects
tachy
palpitations
dyrhythmias
irritablity
resltessness
tremors
headache
euphoria
confusion
seizures
dry mouth
vomiting
ED
Anorexiants
cause stimulant effect on hypothalamic and limbic areas of the brain to suppress appetite
do not give to children under 12
anorexiants side effects
nervousness
irritability
insomnia
techy
hypertension
palpitations
seizures
Analeptics
caffeine
analeptics side effects
palpitations
tachy
dysrhythmias
insomnia
nervousness
restlessness
tremors
seizures
Spinal blocks
penetration of the anesthetic to the subarachnoid membrane
epidural block
placement of local anesthetic in the epidural space
caudal block
placed near the sacrum
saddle block
Administered at the lower end of the spinal column to blocked the perineal area
spinal anesthesia
local anesthetic injected into the subarachnoid space
side effects
headache
hypotension
respiratory distress
local anesthetics
block pain at the site where the drug is administered
consciousness is maintained
local anesthetic use
dental procedures
suturing skin
minor surgery (short term)
nerve blocks
diagnostic procedures (lumbar puncture/ thora)
regional blocks
local anesthetic groups
2
esters
amides
low incidence of allergic reaction
lidocaine
procaine
types of anesthetics
general
depresses cns
alleviates pain
causes loss of consciousness
local
pain relief in limited area
anesthetic route of admin
inhalation
IV
PO
topical
local
spinal
Benzodiaepines action
for sleep disorders and anxiety
CS schedule IV drugs
Benzodiazepines
loraepam (ativan)
diazepam (valium)
flurazepam (dalmane)
alprezolam (xanazx)
temazepam (resoril)
triazolam (hilcion)
estazolam (prosom)
quazepam (doral)
nonbenzodiapzimines action
neurotransmitter inhibition
cns depression
duration 4- 6 hours
used to treat short-term insomnia
CS IV
nonbenzodiazepine
zolpidem (Ambien)
Melatonin agonists
Ramelteon (Rozerem)
first FDA hypnotic, not CS
targets melatonin receptors
regulates circadian rhythm
short half-life of 1 - 2.5 hours
melatonin agonist’s side effects
dizziness
fatigue
headache
nausea
suicidal thoughts
balanced anesthesia may include
hypnotic given the night before
premedication
short-acting barbiturate
inhaled gas
muscle relaxants are given as needed
Stages of general anesthesia
STAGE ONE: analgesia (loss of consciousness
STAGE 2: excitement or delirium (depression of cerebral cortex short induction time)
STAGE 3: surgical (the stage where surgery is performed, shallow but fast RR)
STAGE 4: medullary paralysis (toxic stage of anesthesia RR lost and cardiovascular collapse)
inhalation anesthetics
halothane, methoxyflurane, enflurane
provides smooth induction
usually combined with nonbarbiturate (propofol)
analgesic (morphine)
muscle relaxant (pancuronium)
consciousness reoccurs an hour after discontinuation
inhalation anesthetics side effects
respiratory depression
hypotension
dysrhythmias
hepatic dysfunction
malignant hyperthermia
Intravenous Anesthetics
IV
Ketamine, etomidate, droperidol
-rapid onset short duration
Midazolam (versed) Propofol (diprivan)
-patient sedated and relaxed by responsive
topical anesthetics use
mucous membranes
broken or unbroken skin surfaces
burns
Decrease sensitivity of nerve endings in the affected area
topical anesthetic forms
solution
liquid spray
ointment
cream
gel
powder
balanced anesthesia premedication
opioid or analgesic or benzodiazepine
anticoholinergic
Respiratory CNS stimulant use
Post-anesthesia respiratory depression
IV
doxapram (dopram)
respiratory CNS stimulant side effects
headache
dizziness
confusion
tachycardia
flushing
sweating
CNS depressants
sedative-hypnotics
anesthetics
CNS depressant use
decrease the perception of pain
induce sleep and relaxation
decrease LOC
decrease muscle tone
reduce impulses to the brain
insomnia
more common in females
treatment sedative hypnotics
insomnia nonpharm management
get up at the same time each day
no naps
warm fluids to drink
avoid caffeine 6 hours before bedtime
avoid heavy meals and exercise before bed
warm bath
quiet environment
sedative
produce mildest form of CNS depression
sedative-hypnotics
barbiturates
benzodiazapines
nonbenzodiazepines
sedative-hypnotics side effects
residual drowsiness
vivid dreams/ nightmares
drug dependence
drug tolerance
excessive depression
respiratory depression
hypersensitivity
withdraw symptoms
barbiturates interactions
alcohol
opioids
other sedative-hypnotics
barbiturates
short or intermediate-acting
short term use
CS 2, 3, 4
