SEDATIVE HYPNOTICS Flashcards
main reason for being prescribed a sedative hypnotic
**insomnia
anxiety
what is the clinical definition of insomnia
difficulty sleeping or staying asleep for 3 weeks-month
or
takes longer than 30 min to fall asleep
the drug of choice for short term insomnia
benzodiazepines
prototype benzodiazepines
lorazepam (ativan)
if a drug ends in pam it is a
benzodiazepine
are benzodiazepines given long term, yes or no
no - 3 weeks to a month max.
benzodiazepines are given short term, why?
CNS depressant (respiratory)
highly addictive
increased tolerance
most addictive benzo
Xanax
why is Xanax the most addictive
works quickly
5 benzos, what are they
ativan xanax valium klonopin restoril
how can benzos be taken
PO, IV, IM
small dose benzos are given to treat
anxiety
larger dosed benzos are given to treat
insomnia
therapeutic uses for benzos
muscle spasms
seizure disorders
alcohol withdrawal
why are benzos given for seizures
decreases electrical impulses in the brain, provides rest/relaxation
MOA of benzos
binds to GABA receptors in brain - rest/relaxation
amplifies/intensifies GABA effect
cross blood-brain barrier
when benzos are taken with alcohol what can happen
respiratory depression - hypo-tension -bradycardia
will on benzos you are considered a fall risk, t or f
true
s/e of benzos
decreased coordination behavioral changes respiratory depression cognitive impairment teratogenic elderly considerations (effects x10, effects last longer)
abuse potential for benzos can be seen after
10 doses
why is there an abuse potential with benzos
reducing anxiety (calming aura) intensifying effects of GABA
*withdrawal symptoms of benzos
seizures - prolonged/life threatening
drug interactions with benzos
alcohol, opiods, barbiturates
tagamet interaction
***overdose on benzo s/s
lethargy
confusion
cardio/resp depression
***reversal for suspected iv benzo overdose
***romazicon (iv push) - repeated until drug clears system
**reversal for suspected PO benzo overdose
**emetic - gastric lavage
barbiturates are given via these routes
PO - IM- IV
barbiturates are given for
prevent seizures - medically induced coma
OR as part of anesthesia
what are barbiturates
powerful CNS depressant
mimics GABA
overdose is common w/barbiturates, t or f
true
benzos are safer than barbiturates, t or f
true
why are benzos safer than barbiturates
increased tolerance
very strong effect on GABA
s/e of barbiturates
hyper-sensitivity to pain
respiratory depressant (lethal)
less response to pain mgmt w/opiods
reversal for suspected/confirmed barbiturate overdose
none - supportive care (warming blanket, oxygen)
most common benzo-diazepine like drug
ambien
benzo-diazepine like drug route of administration
PO
MOA for ambien
intensifies effect of GABA but only works on 1 type of receptor
induces sleep
is ambien ever prescribed for anxiety
no - induces sleep - hypnotic effect
s/e of ambien
sleep walking
no recollection
most common OTC med for insomnia
antihistamines: benadryl - diphenhydramine
melatonin
with insomnia there is always an underlying cause t or f
true
