Pharmacology and the Nursing Process
8th Edition Elsevier
CNS depressants - ANSWERS-Sedatives
-inhibits; nervousness, excitability, and irritability
Hypnotics
- induces sleep
-more potent CNS effect
Sedative - Hypnotic - ANSWERS-Dose dependent - sedatives can become hypnotic if
given in a large enough dose
-high dose calms CNS to cause sleep
-low dose calms CNS w/o inducing sleep
Barbiturates
Benzodiazepines
Misc
Sleep - ANSWERS-REM
Non-REM
REM-interference = fatigue
REM-rebound = vivid dreams
Benzodiazepines (Class IV) - ANSWERS-Sedative - Hypnotic
Anxiolytic
-relieve anxiety
MOA: hypothalamic, thalamic, and limbic systems (GABA receptors inhibiting over
stimulation) does
Indication: sedation, skeletal muscle relaxation, anxiety/depression, acute seizure
disorder, ETOH withdrawal, short term insomnia tx
Contra: narrow angle glaucoma, pregnancy
AE/SE: Fall risk, the greater the dose the greater the AE, not w/ ETOH, MUST
TAPPPER to avoid rebound insomnia
Antidote: Flumazelin
,S/S tox somnolence, confusion, diminished reflex, coma (O2, ariway management,
H2O)
RX - RX: Azole antifungals, ditiazem, pretease inhibitor, macrolide antibiotics, grapefruit
juice, CNS depressants, opiods, olanzapine, rifampin
kava and valerian supplements
Flumazelin - ANSWERS-(short half life with 1-4 duration)
used to acutely reverse the sedative effect with OD and use with other CNS
depressants such as alcohol and barbiturates
0.2 mg prn every 60 sec x 4
managment
0.2 mg over 30 sec wait 30 sec
0.3 mg over 30 sec wait 30 sec
0.5 mg over 30 sec over 60 sec x 6 to equal 3mg
Benzodiazepines subclass - ANSWERS-Long-acting (tx anxiety)
-diazepam "Valium"
-Clonazepam "Klonopin"
-flurazepam "Dalmana"
Intermediate (tx conscious sedation - amnesic effect)
-alprazolam "Xanax"
-loraepam "Ativan"
-temazepam "Restoril"
Short - acting (tx - sleep aids)
-midazolam "Versed"
-zolpidem "Ambien"
-triazolam "Halcion"
-eszopiclone "Lunesta"
-ramelteon "Rozerem"
-zaleplon "Sonata"
Barbiturates subclass - ANSWERS-Ultrashort (tx short surgical anesthesia)
-methoexital IV
-thiopental III
Short (tx sedation and convulsion)
-pentobarbital II
-secobarbital II
Intermediate (tx sedation and convulsion)
-butabarbital III
Long (tx
, -phenobarbital IV
-mephobarbital IV
Barbiturates (class II,, III, IV) - ANSWERS-habit forming with a low therapeutic index
MOA: effect the reticular area of the brain-stem to reduce the (GABA) nerve impulses
traveling to the cerebral cortex
Indication: seizure, short term anesthesia, inter-cranial pressure reduction, therapeutic
coma
Contra: pregnancy, respiratory difficulties, liver and kidney disease,
AE/SE: decreases R.R. Fall risk in the elder - ortho hypo d/t vasodialation, deprived
REM increased agitation,
Tox S/S: no antidote, symptomatic and supportive tx
RX-RX increased metabolism of anticoagulants
OTC hypnotics - ANSWERS-Nonprescription sleep aids containing antihistamine
doxylamine "Unisom"
diphenhydramine " Somiex"
acetaminophen/diphenhyramine "TYLENOL PM"
CNS depressant NI - ANSWERS-Assess: sleep habits, BP supine and erect, other CNS
depressants (ETOH), risk for abuse,
Muscle relaxants - ANSWERS-Indication: musculoskeletal condition (often with physical
therapy) spastic or sever chronic conditions i.e MS and cerebral palsy. Can act centrally
or direct.
Contra: renal disease
AE/SE: euphoria, lightheaded, dizzy, drowsy, fatigue, muscle weakness
Tox S/S: no antidote, symptomatic and supportive tx
Antiepiletic - ANSWERS-Seizure - brief episode of abnormal activity in the nerve cells of
the brain
Convulsion - involuntary spasmodic contraction of any or all involuntary muscles
Epilepsy - chronic, recurrent pattern of seizure
Classification of epilepsy - ANSWERS-Generalized onset
-tonic clonic
-absence
Partial onset
-Simple
8th Edition Elsevier
CNS depressants - ANSWERS-Sedatives
-inhibits; nervousness, excitability, and irritability
Hypnotics
- induces sleep
-more potent CNS effect
Sedative - Hypnotic - ANSWERS-Dose dependent - sedatives can become hypnotic if
given in a large enough dose
-high dose calms CNS to cause sleep
-low dose calms CNS w/o inducing sleep
Barbiturates
Benzodiazepines
Misc
Sleep - ANSWERS-REM
Non-REM
REM-interference = fatigue
REM-rebound = vivid dreams
Benzodiazepines (Class IV) - ANSWERS-Sedative - Hypnotic
Anxiolytic
-relieve anxiety
MOA: hypothalamic, thalamic, and limbic systems (GABA receptors inhibiting over
stimulation) does
Indication: sedation, skeletal muscle relaxation, anxiety/depression, acute seizure
disorder, ETOH withdrawal, short term insomnia tx
Contra: narrow angle glaucoma, pregnancy
AE/SE: Fall risk, the greater the dose the greater the AE, not w/ ETOH, MUST
TAPPPER to avoid rebound insomnia
Antidote: Flumazelin
,S/S tox somnolence, confusion, diminished reflex, coma (O2, ariway management,
H2O)
RX - RX: Azole antifungals, ditiazem, pretease inhibitor, macrolide antibiotics, grapefruit
juice, CNS depressants, opiods, olanzapine, rifampin
kava and valerian supplements
Flumazelin - ANSWERS-(short half life with 1-4 duration)
used to acutely reverse the sedative effect with OD and use with other CNS
depressants such as alcohol and barbiturates
0.2 mg prn every 60 sec x 4
managment
0.2 mg over 30 sec wait 30 sec
0.3 mg over 30 sec wait 30 sec
0.5 mg over 30 sec over 60 sec x 6 to equal 3mg
Benzodiazepines subclass - ANSWERS-Long-acting (tx anxiety)
-diazepam "Valium"
-Clonazepam "Klonopin"
-flurazepam "Dalmana"
Intermediate (tx conscious sedation - amnesic effect)
-alprazolam "Xanax"
-loraepam "Ativan"
-temazepam "Restoril"
Short - acting (tx - sleep aids)
-midazolam "Versed"
-zolpidem "Ambien"
-triazolam "Halcion"
-eszopiclone "Lunesta"
-ramelteon "Rozerem"
-zaleplon "Sonata"
Barbiturates subclass - ANSWERS-Ultrashort (tx short surgical anesthesia)
-methoexital IV
-thiopental III
Short (tx sedation and convulsion)
-pentobarbital II
-secobarbital II
Intermediate (tx sedation and convulsion)
-butabarbital III
Long (tx
, -phenobarbital IV
-mephobarbital IV
Barbiturates (class II,, III, IV) - ANSWERS-habit forming with a low therapeutic index
MOA: effect the reticular area of the brain-stem to reduce the (GABA) nerve impulses
traveling to the cerebral cortex
Indication: seizure, short term anesthesia, inter-cranial pressure reduction, therapeutic
coma
Contra: pregnancy, respiratory difficulties, liver and kidney disease,
AE/SE: decreases R.R. Fall risk in the elder - ortho hypo d/t vasodialation, deprived
REM increased agitation,
Tox S/S: no antidote, symptomatic and supportive tx
RX-RX increased metabolism of anticoagulants
OTC hypnotics - ANSWERS-Nonprescription sleep aids containing antihistamine
doxylamine "Unisom"
diphenhydramine " Somiex"
acetaminophen/diphenhyramine "TYLENOL PM"
CNS depressant NI - ANSWERS-Assess: sleep habits, BP supine and erect, other CNS
depressants (ETOH), risk for abuse,
Muscle relaxants - ANSWERS-Indication: musculoskeletal condition (often with physical
therapy) spastic or sever chronic conditions i.e MS and cerebral palsy. Can act centrally
or direct.
Contra: renal disease
AE/SE: euphoria, lightheaded, dizzy, drowsy, fatigue, muscle weakness
Tox S/S: no antidote, symptomatic and supportive tx
Antiepiletic - ANSWERS-Seizure - brief episode of abnormal activity in the nerve cells of
the brain
Convulsion - involuntary spasmodic contraction of any or all involuntary muscles
Epilepsy - chronic, recurrent pattern of seizure
Classification of epilepsy - ANSWERS-Generalized onset
-tonic clonic
-absence
Partial onset
-Simple
