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HESI PHARMACOLOGY REVIEW > CNS DEPRESSANTS > Flashcards

CNS DEPRESSANTS Flashcards

(61 cards)

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1
Q

Are sedative-hypnotics dose dependant?

Are sedative hypnotics dose dependant? Yes or No

A

Yes

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2
Q

What is the meaning of dose dependant?

A.Refers to the effects of treatment with a drug

A

A response that measures how a drug’s effect (response) changes as the administered dose increases

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3
Q

True or False At high doses, calm the CNS without inducing sleep

A

False

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4
Q

True or False At high doses, calm the CNS to the point of causing sleep

A

True

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5
Q

CNS Depressants are classified into what three main groups?

A

Barbiturates
Benzodiazepines
Miscellaneous drugs

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6
Q

What were the most formerly commonly prescribed sedative-hypnotic drugs?

A

Benzodiazepines

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7
Q

Nonbenzodiazepine medications are currently more frequently prescribed now, True or False?

A

True

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8
Q

CNS Depressants: Benzodiazepines have two classifications. Can you name them?

A

1) Sedative-hypnotic
2) Anxiolytic (medication that relieves anxiety

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9
Q

What is the action of Benzodiazepines? There are three actions.

A

1) To enhance the action of gamma- aminobutyric acid (GABA) in the CNS. 2)Depress CNS activity
3) Affect hypothalamic, thalamic, and limbic systems of the brain

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10
Q

What are four Benzodiazepines Drug Effects?

A

1)Calming effect on the CNS
2)Useful in controlling agitation and anxiety
3) Reduce excessive sensory stimulation, 4) inducing sleep
Induce skeletal muscle relaxation

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11
Q

Can you name a few therapeutic uses for Benzodiazepines?

A

1) Anxiety 2) Seizure disorders 3) Insomnia 4) Muscle spasm 5) ETOH withdrawal 6) Panic disorder 6) Induction of anesthesia 7) Anxiety-related depression

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12
Q

What are a few contraindications for Benzodiazepines?

A

Drug allergy
Narrow-angle glaucoma
Pregnancy
Sleep Apnea
Resp. Depression
Organic brain disease

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13
Q

Name a few Benzodiazepines
Adverse Effects

A

Mild and infrequent:
Headache
Drowsiness
Dizziness
Cognitive impairment
Vertigo
Lethargy
Fall hazard for older adults
“Hangover” effect or daytime sleepiness
Incoordination

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14
Q

Benzodiazepines: Acute Toxicity and Overdose Signs and Symptoms-Can you name a few ?

A

Somnolence
Confusion
Coma
Diminished reflexes
Drowsiness
Lethargy

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15
Q

What medication is given to counteract sedation and reverse the effects from a Benzodiazepine?

A

Flumazenil

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16
Q

How is Flumazenil administered?

A

0.2 mg IV over 15 seconds if after 45 seconds no response administer 0.2 mg IV again over one minute and may repeat at one minute intervals, but not to exceed 4 doses or one mg.

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17
Q

Name a few drug interactions with Benzodiazepines

A

CNS depressants (alcohol, opioids) ( *** most dangerous) Azole antifungals, verapamil, diltiazem, protease inhibitors, macrolide antibiotics, grapefruit juice
Olanzapine
Rifampin
Herbal Interactions
Food-drug Interactions

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18
Q

What is the indication for the herbal drug Kava?

A

Used to relieve anxiety, stress, and restlessness and to promote sleep

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19
Q

True or False: Kava
has low potential interactions with alcohol, barbiturates, and psychoactive drugs

A

False high

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20
Q

Kava is contraindicated in liver disease and alcoholism, True or False

A

True

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21
Q

Kava can cause a purple skin discoloration over a long-term use, True or False

A

False it can cause a yellow discoloration

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22
Q

Kava can have potential interactions with alcohol, barbiturates, and psychoactive drugs, True or False

A

True

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23
Q

What is the indication for the Herbal Product: Valerian?

A

Used to relieve anxiety, restlessness, and insomnia

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24
Q

Name a few adverse effects for Valerian.

A

May cause CNS depression, hepatotoxicity, nausea, vomiting, anorexia, restlessness, insomnia

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25
Name a few drug interactions with Valerian.
CNS depressants, MAOIs, phenytoin, warfarin, and alcohol
26
Valerian is contraindicated in what three conditions?
Contraindicated in cardiac, renal and liver disease
27
What was the first clinically available benzodiazepine drug? A. Lorazepam B. Oxazepam C. Midazolam D. Diazepam
D. Diazepam (Valium)
28
Why or what is the purpose for prescribing Diazepam (Valium)?
Treatment of anxiety Procedural sedation and anesthesia adjunct Anticonvulsant therapy Skeletal muscle relaxation
29
Diazepam is available in multiple routes for administration, True or False
True
30
Respiratory depression can occur with IV administration True or False
True
31
Physical dependence can present as withdrawal following short-term use. The symptoms can manifest as anxiety, insomnia, tremors, dizziness and sweating. True or False
True
32
Diazepam withdrawal following long-term use manifests as paranoia, delirium, panic, hypertension, muscle twitches, and seizures. True or False
True
33
Benzodiazepine is discontinued slowly by tapering dose over weeks to months, True or False
True
34
A client should be instructed against sudden cessation of a benzodiazepine, True or False
True
35
It is important to monitor clients for 3 weeks after discontinuing a benzodiazepine for indications of withdrawal or recurrence of symptoms. True or False
True
36
Midazolam (Versed) is another benzodiazepine that is a high-alert drug, True or False-why?
True - Because midazolam has a narrow therapeutic index * which means a slight overdose is extremely dangerous, and can lead to excessive sedation, resp depression, and potential death.
37
What is the indication for Midazolam (Versed)?
Used preoperatively and for moderate sedation, causes amnesia and reduced anxiety
38
The route of administered is by injection in adults A liquid oral dosage form is also available for children, True or False
True
39
Temazepam (Restoril) Intermediate-acting benzodiazepine, which normally induces sleep within 2 hours. True or False
False, it normally induces sleep within 20 to 40 minutes
40
A nurse should administer Restoril to a client one hour prior to going to sleep. True or False
True
41
Nonbenzodiazepine: Eszopiclone (Lunesta) was the first hypnotic to be FDA approved for long-term use. True or False
True
42
Lunesta is designed to provide a full 8 hours of sleep Considered a short- to intermediate-acting agent, and should not be taken if a person must awaken in 6–8 hours, True or False
True
43
The therapeutic use of Eszopiclone (Lunesta) is the short-term management of insomnia, True or False
True
44
Warnings pregnancy can increase the risk of respiratory depression in neonates after birth and use cautiously in persons > 65 who have impaired kidney, liver or respiratory function while using nonbenzodiazepines True or False
True
45
Nonbenzodiazepine: Ramelteon (Rozerem is a melatonin agonist True or False
True
46
What is the action of Ramelteon?
Activation of the melatonin receptors and used a hypnotic
47
What is the therapeutic use for Ramelteon?
Indicated for patients who have difficulty with sleep onset rather than sleep maintenance Also, for the management of chronic insomnia
48
True or False, Ramelteon is a scheduled controlled substance drug.
False
49
Ramelteon is a CNS depressant True or False
False
50
Nonbenzodiazepine: Zolpidem (Ambien) is a short-term management of insomnia, True or False
True
51
Nonbenzodiazepine is for the therapeutic management of chronic insomnia, True or False
False it is for the short-term use of insomnia
52
Ambien CR is a longer acting form with two separate drug reservoirs. True or False
True
53
Sleepwalking (somnambulation)is a concern with Ambien True or False
True
54
Orexin Receptor Antagonists- orexin is known as a hypocretin, True or False
True
55
Orexin Receptor Antagonists are a class of medications primarily used to treat insomnia (the drug names end in ant, True or False
True
56
Orexin binds to orexin receptors (OX1R & OX2R in the brain, triggering signals that keep you awake
True
57
Orexin are contraindicated in narcolepsy True or False
True
58
Adverse effects are more common in men while taking orexin. True or False
False
59
Name a few adverse effects for Suvorexant (Belsomra) .
Adverse effects: drowsiness, headache, dizziness, diarrhea, dry mouth, cough, increased serum cholesterol
60
What are a few safety concerns for drugs in this class?
Safety concerns: daytime somnolence and unconscious nighttime behaviors
61
Drugs in this class have a 12 hour or 8 hour half life?
12 hour

HESI PHARMACOLOGY REVIEW (3 decks)

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