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