Sedative-Hypnotics Flashcards
sedative-hypnotic drugs classes (5)
1 benzodiazepines
2 propofol
3 barbiturates
4 ketamine
*benzodiazepines
AE + Indications
AE: RR depress, low BP
used for many indications
propofol
CI
allergies to eggs + soy
–propofol looks like soy milk
propofol
AE
- apnea
- low BP
- low HR
*propofol
RN/teaching
- change tubing Q12hrs
- use spiked infusion vials w/in 12hr
- for procedural sedation, use open bottle w/in 6hr
barbiturates
drug
pentobarbital
phenobarbital
barbiturates
AE
- resp depress
- low BO
- need EKG
ketamine
AE + indications
AE: hallucinations
-good for BP concerns + RR concerns (asthma)
benzodiazepines
drugs (5)
CHLORDIAZEPOXIDE lorazepam midazolam diazepam alprazolam
benzodiazepines
MOA
incr GABA in CNS
benzodiazepines
Tx
- seizures
- anxiety
- panic attacks
- insomnia
- muscle spasm
- procedural sedation
- deep sedation
- ETOH WD
- induction
- asthma
- drug WD
- combative patients
- date rape drug
*benzodiazepines
CI
*CNA DEPRESSANTS sleep apnea resp problems -liver disease *category D + X
*benzodiazepines
AE (9)
1 resp depress 2 anterograde amnesia 3 drowsy, lethargy 4 CNS depress 5 ataxia>imbalanced gait>fall risk 6 hypotension 7 toxicity>use reversal agents 8 paradoxical effects>hyperactive + euphoric 9 phys dependence>sched med>taper
*benzodiazepines
RN/teaching (7)
1 don’t push fast (PEDS)
2 keep cart near
3 check BP + RR before +after
4 midazolam should be on bedside w HR monitor + EKG
5 taper off> withdrawal symp (tremor, sweat)
6 watch use w former addicts
7 cannot drive home > accompany after DC
atypical anxiolytic drug
NON-BENZO
buspirone
Buspirone
MOA
- weak agonist for serotonin + dopamine
- doesnt cause dependence
*why would you NOT use buspirone for panic attacks?
- onset is 3-6 wks
- not used for PRN
- GREAT FOR CHRONIC ANXIETY
Buspirone
a/e
nausea dizzy
Atypical Hypnotics
drugs (4)
zolpidem
ramelteon
trazodone
antihistamine (diphenhydramine)
*zolpidem
indication + teaching
to MAINTAIN SLEEP
-use less than 2 wks bc habit forming + tolerance
zolpidem
AE
withdrawal dizzy sleepy in daytime abnormal thought sleep walking
*ramelteon
indication
melatonin agonist
TO HELP FALL ASLEEP
—NOT to maintain sleep
ramelteon
AE
galactorrhea
ramelteon
RN/teaching
- DONT take w high fat meals
- use on empty stomach
tradozone
25mg QHS prn sleep
diphenydramine
indications
aka benadryl
OTC/PRN antihistamine
for seasonal allergies + for Insomnia
CNS depressant.
which drug to give for trouble falling asleep vs trouble staying asleep?
ramelteon for FALLING
zolpidem for STAYING
all sedative-hypnotic drugs lower resp rate + BP except for ___
ketamine
drug class used for alcohol withdrawal?
benzos: lam, pam, chlordiaz
ETOH + benzo decr CNS
which benzo is used for panic attacks?
lorezapam (Atavvan)
which benzo is used for procedural sedation?
midazolam is the only one that causes cardiac arrest
must always have bedside heart rate monitor
which drug is great for chronic anxiety?
buspirone (non-benzoid)
