Neurologic/Neuromuscular/Pain Agents Flashcards
Sedative/Hypnotic classifications
- Barbiturates
- Benzodiazepines
- Nonbenzodiazepines
Barbiturates
- indication: insomnia, sedation prior to anesthesia, seizures
- action: depresses CNS causing mild sedation or sleep depending on dose
- side effects: think DEPRESSION (lethargy, drowsiness, hangover, REM rebound, dependence, tolerance, excessive depression, respiratory depression, ↓ BP)
- interactions: no alcohol, no other CNS depressants
long acting barbiturates
seizures
intermediate and short acting barbiturates
sleep
ultra short barbiurates
general anesthetic
Barbiturates have been implicated in many…
suicides and fatalities due to accidental overdoses esp when combined with alcohol and other CNS depressants
Elderly and barbiturates
- paradoxical rxn w/ hypersensitivity, confusion, and hallucinations
- Seconal on BEERs
Barbiturate Prototype
Secobarbital Sodium (Seconal)
Benzodiazepines
indication: anxiety, seizures, sedative (insomnia)
action: depresses CNS, ↑ GABA, ↓ neuron excitability, helps regulate anxiety
side effects: think depression, drowsiness, lethargy, depression, ↓ BP, resp depression, dizziness
interactions: no alcohol, no other CNS depressants
Benzodiazepines antidote
flumazenil (Romazicon) for OD or to reverse sedative effects of benzodiazepines used with general anesthesia
Benzodiazepines prototypes
- lorazepam
- alprazolam
GABA
inhibitory enzyme, acts as neurotransmitter in the CNS
dosage of Benzodiazepines
- short term use only
- no longer than 3-4 wks to prevent REM rebound
- high abuse class IV
ADR of benzodiazepines
- apnea
- cardiac arrest
Nursing implications for patients on benzodiazepines
- renal, hepatic, and hematologic function labs
- assess anxiety
- geri: fall risk
- meds as directed
- advise on short term
- use other anxiety reducing methods
- psychotherapy
- no driving
- no CNS depressants
