Week #4 Exam Questions and Complete
Solutions Graded A+
Types of Anxiolytic and Hypnotic Agents - Answer: All have an effect on Affect
Anxiolytics - Prevent feelings of tension or fear (anti-anxiety medications)
Sedatives - Calm and make patients unaware of the environment (benzodiazepines)
Hypnotics - Cause sleep (ambian)
Minor Tranquilizers - Produce a state of tranquility in anxious patients
Benzodiazepine: Action - Answer: - Act in the limbic system and the RAS
- Make GABA more effective (neurotransmitter)
- Causes interference with neurons firing
- Lower doses assist with anxiety
- Higher doses cause sedation and hypnosis
- Affect the CNS
Benzodiazepine: Indications - Answer: - Anxiety disorders
- Alcohol withdrawal
- Hyperexcitability and agitation
- Preoperative relief of anxiety and tension
- Seizure disorder (rarely used)
Benzodiazepine: Pharmacokinetics - Answer: - Well absorbed from GI tract (PO)
- Peak levels achieved in 30 minutes to 2 hours
,- Lipid soluble and distributes well throughout the body (crosses the blood brain barrier easily)
- Cross placenta
- Enter breast milk
- Metabolized in the liver
- Excretion is primarily in the urine
Benzodiazepine: Contraindications and Cautions - Answer: - Allergy to benzodiazepine
- Psychosis
- Acute narrow angle glaucoma
- Shock
- Coma
- Acute alcohol intoxication
- Pregnancy
- Renal or hepatic dysfunction (unless no other options) If given, give on a low dose
Benzodiazepine: Adverse Effects - Answer: Sedation
Drowsiness
Depression
Lethargy
Blurred Vision
Confusion
Dry Mouth
Constipation
Nausea
Vomiting
Hypotension
Urinary Retention
*With prolonged use there is a risk of dependency & withdrawal - for short term use only*
, *Not as effective long-term*
*Can overdose on it, toxicity*
Benzodiazepine: Drug-to-Drug Interactions - Answer: Increase CNS depression when taken with alcohol
Increase in effect when taken with cimetidine, oral contraceptives, or disulfiram
Decrease in effect if given with theophylline or ranitidine
Antacids delay absorption (wait 2 hours after taking antacids)
Smoking on lorazopam can decrease antianxiety and sedative effects
Nursing Considerations for Benzodiazepines - Answer: - Physical
- Known allergies to benzodiazepines
- Impaired liver or kidney function
- Baseline status before beginning therapy
- VS, lesions; affect, orientation, reflexes, and vision
- Renal and liver function tests and complete blood count (CBC).
- Suicidality
- - Hypotension, bradycardia
- If pushing via IV: give slowly over 1 minute for every 5 mg (Diazepam) - if you push too fast the patient
could end up in cardiac arrest
Flumazenil - can give that if someone overdoses on Benzodiazepines
A client presents at the clinic with symptoms of hyperexcitability and agitation. Which medication would
the nurse expect the physician to prescribe?
A. Hypnotic
B. Benzodiazepine
Solutions Graded A+
Types of Anxiolytic and Hypnotic Agents - Answer: All have an effect on Affect
Anxiolytics - Prevent feelings of tension or fear (anti-anxiety medications)
Sedatives - Calm and make patients unaware of the environment (benzodiazepines)
Hypnotics - Cause sleep (ambian)
Minor Tranquilizers - Produce a state of tranquility in anxious patients
Benzodiazepine: Action - Answer: - Act in the limbic system and the RAS
- Make GABA more effective (neurotransmitter)
- Causes interference with neurons firing
- Lower doses assist with anxiety
- Higher doses cause sedation and hypnosis
- Affect the CNS
Benzodiazepine: Indications - Answer: - Anxiety disorders
- Alcohol withdrawal
- Hyperexcitability and agitation
- Preoperative relief of anxiety and tension
- Seizure disorder (rarely used)
Benzodiazepine: Pharmacokinetics - Answer: - Well absorbed from GI tract (PO)
- Peak levels achieved in 30 minutes to 2 hours
,- Lipid soluble and distributes well throughout the body (crosses the blood brain barrier easily)
- Cross placenta
- Enter breast milk
- Metabolized in the liver
- Excretion is primarily in the urine
Benzodiazepine: Contraindications and Cautions - Answer: - Allergy to benzodiazepine
- Psychosis
- Acute narrow angle glaucoma
- Shock
- Coma
- Acute alcohol intoxication
- Pregnancy
- Renal or hepatic dysfunction (unless no other options) If given, give on a low dose
Benzodiazepine: Adverse Effects - Answer: Sedation
Drowsiness
Depression
Lethargy
Blurred Vision
Confusion
Dry Mouth
Constipation
Nausea
Vomiting
Hypotension
Urinary Retention
*With prolonged use there is a risk of dependency & withdrawal - for short term use only*
, *Not as effective long-term*
*Can overdose on it, toxicity*
Benzodiazepine: Drug-to-Drug Interactions - Answer: Increase CNS depression when taken with alcohol
Increase in effect when taken with cimetidine, oral contraceptives, or disulfiram
Decrease in effect if given with theophylline or ranitidine
Antacids delay absorption (wait 2 hours after taking antacids)
Smoking on lorazopam can decrease antianxiety and sedative effects
Nursing Considerations for Benzodiazepines - Answer: - Physical
- Known allergies to benzodiazepines
- Impaired liver or kidney function
- Baseline status before beginning therapy
- VS, lesions; affect, orientation, reflexes, and vision
- Renal and liver function tests and complete blood count (CBC).
- Suicidality
- - Hypotension, bradycardia
- If pushing via IV: give slowly over 1 minute for every 5 mg (Diazepam) - if you push too fast the patient
could end up in cardiac arrest
Flumazenil - can give that if someone overdoses on Benzodiazepines
A client presents at the clinic with symptoms of hyperexcitability and agitation. Which medication would
the nurse expect the physician to prescribe?
A. Hypnotic
B. Benzodiazepine
