Pharmacology for Sleep/Anxiety Flashcards
Benzodiazepines
MOA???
promote the activity of GABA by binding to a specific site – which results in an increased frequency of chloride channel opening–
causing membrane hyperpolarization–
which reduces cell excitation–
result is a calming effect
Benzodiazepines
Indication/ Contraindications
Indicated for GA and panic disorders, insomnia, alcohol withdrawal, seizures, muscle spasms
Contraindicated in pregnancy, sleep apnea, respiratory depression, glaucoma,
use caution in older adults, liver disease, history of substance abuse
Benzodiazepines
Side effects
sedation, ataxia, anterograde amnesia, respiratory depression, rage, euphoria, nausea, vomiting, anorexia
Benzodiazepine
Nursing Considerations
Schedule IV controlled substance
administer with meals or snacks to avoid GI upset
admin at bedtime for sedation effects
this medication has addictive properties so only indicated for a short period of time
Benzodiazepine
Exemplars
Diazepam
Clonazepam
Alprazolam
Lorazepam
Triazolam
Flurazepam
Temazepam
Nonbenzos OR Z-hypnotics
MOA???
Enhance the action of GABA in the CNS–
results in prolonged sleep duration and decreased awakening
NonBenzos
indc./Contr.
Indicated for short term management of insomnia
Contraindicated in pregnancy, breastfeeding
exercise caution in older adults and in patients with impaired kidney, liver, or resp. function
NonBenzos
Nursing Considerations
Administer at night with at least 8 hours of sleep
more rapid absorption occurs when the medication is taken on an empty stomach
there is a low risk for tolerance, substance use disorder and dependence
Nonbenzos
Exemplars
Zolpidem
Zaleplon
Eszopiclone
Melatonin receptor agonists
MOA: activates melatonin receptors
Indicated for insomnia
Contraindicated in pregnancy, lactation, liver disease, depression, apnea, COPD
Side effects: headache, dizziness, fatigue,
Ramelteon
Doxepin
Suvorexant
Buspirone
SSRIs
