Sedative-Hypnotics Flashcards

1
Q
sedative-hypnotic 
drugs classes (5)
A

1 benzodiazepines
2 propofol
3 barbiturates
4 ketamine

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2
Q

*benzodiazepines

AE + Indications

A

AE: RR depress, low BP

used for many indications

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3
Q

propofol

CI

A

allergies to eggs + soy

–propofol looks like soy milk

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4
Q

propofol

AE

A
  • apnea
  • low BP
  • low HR
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5
Q

*propofol

RN/teaching

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

barbiturates

drug

A

pentobarbital

phenobarbital

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7
Q

barbiturates

AE

A
  • resp depress
  • low BO
  • need EKG
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8
Q

ketamine

AE + indications

A

AE: hallucinations

-good for BP concerns + RR concerns (asthma)

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9
Q

benzodiazepines

drugs (5)

A
CHLORDIAZEPOXIDE
lorazepam
midazolam
diazepam
alprazolam
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10
Q

benzodiazepines

MOA

A

incr GABA in CNS

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11
Q

benzodiazepines

Tx

A
  • seizures
  • anxiety
  • panic attacks
  • insomnia
  • muscle spasm
  • procedural sedation
  • deep sedation
  • ETOH WD
  • induction
  • asthma
  • drug WD
  • combative patients
  • date rape drug
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12
Q

*benzodiazepines

CI

A
*CNA DEPRESSANTS
sleep apnea
resp problems
-liver disease
*category D + X
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13
Q

*benzodiazepines

AE (9)

A
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
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14
Q

*benzodiazepines

RN/teaching (7)

A

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

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15
Q

atypical anxiolytic drug

NON-BENZO

A

buspirone

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16
Q

Buspirone

MOA

A
  • weak agonist for serotonin + dopamine

- doesnt cause dependence

17
Q

*why would you NOT use buspirone for panic attacks?

A
  • onset is 3-6 wks
  • not used for PRN
  • GREAT FOR CHRONIC ANXIETY
18
Q

Buspirone

a/e

A

nausea dizzy

19
Q

Atypical Hypnotics

drugs (4)

A

zolpidem
ramelteon
trazodone
antihistamine (diphenhydramine)

20
Q

*zolpidem

indication + teaching

A

to MAINTAIN SLEEP

-use less than 2 wks bc habit forming + tolerance

21
Q

zolpidem

AE

A
withdrawal
dizzy
sleepy in daytime
abnormal thought
sleep walking
22
Q

*ramelteon

indication

A

melatonin agonist

TO HELP FALL ASLEEP
—NOT to maintain sleep

23
Q

ramelteon

AE

A

galactorrhea

24
Q

ramelteon

RN/teaching

A
  • DONT take w high fat meals

- use on empty stomach

25
tradozone
25mg QHS prn sleep
26
diphenydramine | indications
aka benadryl OTC/PRN antihistamine for seasonal allergies + for Insomnia CNS depressant.
27
which drug to give for trouble falling asleep vs trouble staying asleep?
ramelteon for FALLING | zolpidem for STAYING
28
all sedative-hypnotic drugs lower resp rate + BP except for ___
ketamine
29
drug class used for alcohol withdrawal?
benzos: lam, pam, chlordiaz ETOH + benzo decr CNS
30
which benzo is used for panic attacks?
lorezapam (Atavvan)
31
which benzo is used for procedural sedation?
midazolam is the only one that causes cardiac arrest must always have bedside heart rate monitor
32
which drug is great for chronic anxiety?
buspirone (non-benzoid)