Sedative-Hypnotics

Question 1

sedative-hypnotic 
drugs classes (5)

Answer 1

1 benzodiazepines
2 propofol
3 barbiturates
4 ketamine

Question 2

*benzodiazepines

AE + Indications

Answer 2

AE: RR depress, low BP

used for many indications

Question 3

propofol

CI

Answer 3

allergies to eggs + soy

–propofol looks like soy milk

Question 4

propofol

AE

Answer 4

• apnea
• low BP
• low HR

Question 5

*propofol

RN/teaching

Answer 5

• change tubing Q12hrs
• use spiked infusion vials w/in 12hr
• for procedural sedation, use open bottle w/in 6hr

Question 6

barbiturates

drug

Answer 6

pentobarbital

phenobarbital

Question 7

barbiturates

AE

Answer 7

• resp depress
• low BO
• need EKG

Question 8

ketamine

AE + indications

Answer 8

AE: hallucinations

-good for BP concerns + RR concerns (asthma)

Question 9

benzodiazepines

drugs (5)

Answer 9

CHLORDIAZEPOXIDE
lorazepam
midazolam
diazepam
alprazolam

Question 10

benzodiazepines

MOA

Answer 10

incr GABA in CNS

Question 11

benzodiazepines

Tx

Answer 11

• seizures
• anxiety
• panic attacks
• insomnia
• muscle spasm
• procedural sedation
• deep sedation
• ETOH WD
• induction
• asthma
• drug WD
• combative patients
• date rape drug

Question 12

*benzodiazepines

CI

Answer 12

*CNA DEPRESSANTS
sleep apnea
resp problems
-liver disease
*category D + X

Question 13

*benzodiazepines

AE (9)

Answer 13

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

Question 14

*benzodiazepines

RN/teaching (7)

Answer 14

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

Question 15

atypical anxiolytic drug

NON-BENZO

Answer 15

buspirone

Question 16

Buspirone

MOA

Answer 16

• weak agonist for serotonin + dopamine

- doesnt cause dependence

Question 17

*why would you NOT use buspirone for panic attacks?

Answer 17

• onset is 3-6 wks
• not used for PRN
• GREAT FOR CHRONIC ANXIETY

Question 18

Buspirone

a/e

Answer 18

nausea dizzy

Question 19

Atypical Hypnotics

drugs (4)

Answer 19

zolpidem
ramelteon
trazodone
antihistamine (diphenhydramine)

Question 20

*zolpidem

indication + teaching

Answer 20

to MAINTAIN SLEEP

-use less than 2 wks bc habit forming + tolerance

Question 21

zolpidem

AE

Answer 21

withdrawal
dizzy
sleepy in daytime
abnormal thought
sleep walking

Question 22

*ramelteon

indication

Answer 22

melatonin agonist

TO HELP FALL ASLEEP
—NOT to maintain sleep

Question 23

ramelteon

AE

Answer 23

galactorrhea

Question 24

ramelteon

RN/teaching

Answer 24

• DONT take w high fat meals

- use on empty stomach

Question 25

tradozone

Answer 25

25mg QHS prn sleep

Question 26

diphenydramine

indications

Answer 26

aka benadryl
OTC/PRN antihistamine
for seasonal allergies + for Insomnia
CNS depressant.

Question 27

which drug to give for trouble falling asleep vs trouble staying asleep?

Answer 27

ramelteon for FALLING

zolpidem for STAYING

Question 28

all sedative-hypnotic drugs lower resp rate + BP except for ___

Answer 28

ketamine

Question 29

drug class used for alcohol withdrawal?

Answer 29

benzos: lam, pam, chlordiaz

ETOH + benzo decr CNS

Question 30

which benzo is used for panic attacks?

Answer 30

lorezapam (Atavvan)

Question 31

which benzo is used for procedural sedation?

Answer 31

midazolam is the only one that causes cardiac arrest

must always have bedside heart rate monitor

Question 32

which drug is great for chronic anxiety?

Answer 32

buspirone (non-benzoid)