Week 13: CNS- sedatives (5 Larkin)

Question 1

What happens if you give too much sedative?

Don’t give sedatives with what?

Answer 1

It becomes a hypnotic

Other CNS depressants and Grapefruit juice

Question 2

Benzodiazepine: Short Acting

Midazolam

Used for?
Expected causes?

Answer 2

Preop & moderate sedation

Causes amnesia, reduced anxiety, & sedation

Question 3

Benzodiazepine: Intermediate-Acting
Temazepam, Lorazepam, Alprazolam

Temazepam

Metabolite of?
Taken when?

Answer 3

One of the metabolites of diazepam

Take 1 hr before going to bed

Very effective, but has been replaced w/ newer drugs

Question 4

Benzodiazepine: Long-Acting
(D,C,F)

Diazepam

Used for?

Answer 4

Treatment of anxiety

Procedural sedation & anesthesia adjunct

***Skeletal muscle relaxation following injury or surgery

Question 5

Benzodiazepines overdose Cues? 4

Antidote for benzo overdose?

Answer 5

Somnolence- drowsiness
Diminished reflexes
Confusion
Coma

ANTIDOTE: flumazenil

Question 6

Benzodiazepine Nursing
Considerations

Gradually?

If giving IV?

Lorazepam IV must be?

Answer 6

Gradually taper to discontinue to decrease risks of withdrawal and/or
seizure activity or status epilepticus

If giving IV route, administer slowly over 2-5 minutes

Lorazepam IV MUST be diluted in a 1:1 ration w/ NS or D5W

Question 7

Hypnotics:
Short-Acting Nonbenzodiazepines

Ramelteon

Like what hormone?

Used as a?

Indicated for?

Answer 7

Structurally like the hormone melatonin

Technically NOT a CNS depressant; used as a hypnotic

Indicated for client’s who have difficulty FALLING ASLEEP rather than sleep maintenance

Question 8

Hypnotics:
Short-Acting NonBenzodiazepines

Zolpidem

Answer 8

Short-acting hypnotic

Lower incidences of daytime sleepiness compared with benzo hypnotics

Ambien CR is currently one of only 2 hypnotics to be approved for long-term use

Question 9

Hypnotics:
Short-Acting Nonbenzodiazepines

Eszopiclone

can be used for?

Designed to provide?

Answer 9

First hypnotic to be FDA approved for long-term use

Designed to provide a full 8 hours of sleep

Question 10

Hypnotics
Short-Acting Nonbenzodiazepines:

Don’t give if?

Don’t administer?

When to give?

Answer 10

sleep apnea
severe hepatic impairment

Do not administer w/ or immediately after a high fat meal

Administer 30 minutes before bed

Question 11

Barbiturates

What can u give for overdose?

what can be used to eliminate phenobarbital?

Answer 11

Activated charcoal

Diuretics can be used to eliminate phenobarbital

Question 12

Barbiturates: Short-Acting

Pentobarbital

what acting?
Primarily used?

Answer 12

short-acting

Primarily used preoperatively to reduce anxiety and provide sedation

Question 13

Barbiturates: Long Acting:

Phenobarbital

Therapeutic blood level?

Used for Prevention of?
and?

Answer 13

Therapeutic blood level is 10-40 mcg/mL

Prevention of generalized tonic-clonic
seizures

Fever-induced convulsions

Question 14

Barbiturates
Nursing Considerations

Monitor for?
Have what available?

assess what post op?

Answer 14

Monitor for angioedema

Have oxygen, resuscitative equipment, and artificial ventilation available

Post-op: pain

Question 15

Herbals- Kava

Used for?
Contraindicated in?
Monitor what?

Answer 15

Better sleep
Fewer awakenings

Liver disease
MONITOR LIVER ENZYMES!!!1

Question 16

Herbals- Valerian

Used for?
Contraindicated in?
Monitor what?

Answer 16

Anxiety, restlessness, and sleep
disorders

Cardiac & liver disease
MONITOR LIVER ENZYMER