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Pharmacology - CNUR 202 > Module 3 - CNS Depressant Agents > Flashcards

Module 3 - CNS Depressant Agents Flashcards

1
Q

CNS depression

A

continuum ranging from relaxation, to sedation, to the induction of sleep and anesthesia

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2
Q

CNS depressants uses

A

anesthesia and to treat anxiety, sleep and seizure disorders

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3
Q

CNS classes

A

Barbiturates
Benzodiazepines
Miscellaneous drugs

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4
Q

sedatives

A

inhibit CNS to Reduce nervousness, excitability, irritability without causing sleep

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5
Q

hypnotics

A

calm and sooth CNS causing sleep

-sedatives administered in high doses become hypnotics

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6
Q

sedative-hypnotic

A
  • At low doses, calm or soothe the CNS without inducing sleep
  • At high doses, calm or soothe the CNS to the point of causing sleep
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7
Q

what does the limbic system control?

A

emotions

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8
Q

reticular activation system

A

processes that trigger anxiety, restlessness, sleep

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9
Q

hypothalmus regulates

A

homeostasis

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10
Q

what is the job of reticular formation

A

sends info to hypothalmus

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11
Q

Gamma-Aminobutyric Acid (Gaba)

A
  • anti-anxiety neurotransmitter produced by glutamate
  • decreased levels cause brain nerves to be overactive and transmit quickly
  • sensitive fight or flight (need sm GABA to initiate normally)
  • characterized by nervousness, mental strain, fear, worry and a variety of anxiety disorders
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12
Q

insomnia includes

A

Difficulty falling asleep
Staying asleep
Non-restorative sleep
In combination with daytime dysfunction or distress

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13
Q

insomnia associated with

A

anxiety
short term - stress
certain foods/ drinks

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14
Q

consequences of insomnia

A

depression, manic disorders, chronic pain

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15
Q

rebound insomnia

A

caused by discontinuation of long term use of sedatives without weening off

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16
Q

Barbiturates

A

hypnotic, sedative, anticonvulsant, anesthesia for surgical procedures

  • narrow therepeutic index
  • not used very often
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17
Q

barbiturate uses

A

Used for reoxidation and uncontrollable seizures put people into barbiturates coma until enough seizure drugs are in blood and then take out of coma

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18
Q

issues with barbituates

A

Increases metabolism of other drugs, affects liver
High chance of abuse and addiction
Suppress
Affects the heart

19
Q

barbituates
category: Ultrashort
route, onset and duration

A

route - IV
onset - less than 15 mins
duration - 2 hours
example - methohexital, thiamylal, thiopental

20
Q

barbituates
category: short
route, onset and duration

A

route- PO
onset - 15-20 min
duration - 2-4 hours
examples- pentobarbital, secobarbital

21
Q

barbituates
category: Intermediate
route, onset and duration

A

route - PO
onset - 20-30 min
duration - 2-4 hours
example - butabarbital

22
Q

barbituates
category: long
route, onset and duration

A

route - PO
onset - 30-60 min
duration - 6-8 hours
example - phenobarbital, mephobarbital

23
Q

barbituates

mechanism of action

A

Site of action
-Inhibits brain impulses from passing through limbic and reticular activating systems (brain stem)

  • Bind to GABA receptor-chloride channel molecule
  • By inhibiting GABA, nerve impulses traveling in the cerebral cortex are also inhibited
24
Q

barbituates

effects

A

-Low doses: sedative effects
-High doses: hypnotic effects and lowers respiratory rate
-Notorious enzyme inducers
Stimulate liver enzymes that cause the metabolism or breakdown of many drugs

Overdose: respiratory depression to arrest; CNS depression (sleep to coma to death)
Can be therapeutic (e.g., anesthesia induction; uncontrollable seizures)

25
Q

barbituates

side effects on nervous system

A

nervous system: Drowsiness, lethargy, vertigo, mental depression, coma

26
Q

barbituates

side effects on cardio vascular system

A

Vasodilatation and hypotension, especially if given to fast

27
Q

barbituates

side effects on respiratory

A

Respiratory depression, apnea, bronchospasms, cough

28
Q

barbituates

side effects on GI

A

nausea/vomiting, diarrhea, constipation

29
Q

barbiturate side effects on Hematology

A

Agranulocytosis, thrombocytopenia, megaloblastic anemia

30
Q

barbiturate

general side effects

A 
Hypersensitivity reactions (rash, fever, urticaria, etc.)
**Reduced REM sleep resulting in agitation and inability to deal with normal stress
31
Q

barbiturate

drug interactions

A

Additive effects
-ETOH, antihistamines, benzodiazepines, narcotics, tranquilizers

Inhibited metabolism
-MAOIs will prolong effects

Increased metabolism
-Reduces anticoagulant response, leading to possible clot formation

32
Q

Benzodiazepines

A

sedative-hypnotic or anxiolytic

  • used for short-term treatment of insomnia caused by anxiety (sedative-hypnotic)
  • safe but can still cause tolerance
33
Q

Benzodiazepines

Indications

A

sedation, sleep induction, skeletal muscle relaxation, anxiety relief, treatment of alcohol withdrawal, agitation, depression, epilepsy, balanced anesthesia

34
Q

what is the problem with benzodiazepines with high potency and short 1/2 life

A

moe likely to lead to problems with dependence

ex) lorazepam, oxazepam and loprazolam

35
Q

what is the problem with benzodiazepines with long 1/2 life

A

residual effects into the following day (feel hungover)

ex) withdrawal less likely

36
Q

what type of benzodiazepine has the least issues

A

intermediate

37
Q

benzodiazepine

mechanism of action

A
  • Depress CNS activity
  • Affect hypothalamic, thalamic, and limbic systems of the brain
  • Benzodiazepine receptors
  • Do not suppress REM sleep as much as barbiturates do
  • Do not increase metabolism of other drugs
38
Q

benzodiazepines

drug effects

A
  • Calming effect on the CNS
  • Useful in controlling agitation and anxiety
  • Reduce excessive sensory stimulation, inducing sleep
  • Induce skeletal muscle relaxation
39
Q

benzodiazepines

side effects

A 
*Mild and infrequent
Headache
Drowsiness
Dizziness
Vertigo
Lethargy
Paradoxical excitement (nervousness)
“Hangover effect”
40
Q

benzodiazepine antidote

A

flumazenil

*has a short half-life - must administer more than once

41
Q

when are benzodiazepines dangerous?

A

when taken with other sedatives or alcohol

42
Q

what are miscellaneous CNS depressants?

A

not benzodiazepines or barbiturates

-treat social anxiety disorder

43
Q

must use CNS depressants cautiously in….

A

the elderly
Those with suicidal potential
Those with impaired renal or liver function
pts

Pharmacology - CNUR 202 (6 decks)

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