CNS Depressants Flashcards
(27 cards)
diazepam is a controlled substance. What schedule is it?
Schedule IV
What is the pharmacologic and therapeutic class for diazepam (Valium)?
Pharmacologic:
- Benzodiazepine
Therapeutic Class:
- Anticonvulsant, Anxiolytic, Sedative-hypnotic
Explain the MOA for diazepam (Valium)
- Bind to allosteric site on GABA-A receptor (Cl- ion channel in CNS) and open channel
- Influx of Cl- ions from ECM
- Cell becomes more negative (hyperpolarization)
- Cell less likely to create action potential = CNS depressant
Nurse josh is taking care of a patient with alcohol withdrawls. Nurse josh wants to administer diazepam or barbital to help with their withdrawls. Nurse karen is like, wtf, why would you prescribe these medications knowing they are CNS depressants?
Nurse josh is correct, but what is the rationale for Nurse josh to administer these drugs?
Alcohol enhanaces GABA activity (depressant) but the brain gets used to all that GABA stimulation and will stop making enough of it naturally
When someone stops drinking alcohol, GABA activity drops sharply and the brain can become hyperexcitable causing seizures, anxiety, tremors, etc
Diazepam helps to restore GABA activity and gives calming effect
A patient wants to be put on diazepam (Valium). What are indications in which a nurse will need to give diazepam?
Indications
- Insomnia
- Alcohol withdrawl
- Anxiety
- Muscle spams
- Seizures
What are general therapeutic effects of diazepam (Valium)?
- Promote Sleep
- Decrease anxiety
- Relax skeletal muscle
Drugs that are part of the benzodiazepine family typically have a common ending of:
- pam
- lam
A patient is taking diazepam. What are some common side effects of this drug?
Side Effects
- Fatigue
- Confusion
- Muscle weakness
- Blurred vision
A patient is taking diazepam. What are some common adverse effects of this drug?
Adverse Effects:
- Respiratory depression
- Sedation
- Sleep walking
- Hypotention
- Shock
A nurse is giving discharge instructions. The patient asks if they can drink wine while taking diazepam.
What is the nurse’s best response?
No — alcohol and benzodiazepines are both CNS depressants. Together, they can cause severe sedation, respiratory depression, or even death
What are foods/drinks that should be avoiding in patients taking diazepam (Valium)?
- Grapefruit juice (may increase level of benzos in the body)
- Caffeine (reduce calming effect)
- Alcohol/Opiods
A patient with insomnia takes diazepam nightly for two weeks straight.
What is the risk of continued use?
Patients should only use diazepam PRN.
It should not be used continuously for two weeks or more because it can affect REM stage 3 sleep and patient may become addicted (bc it will be hard to sleep without it)
T/F: Alcohol can cross the BBB and cause an additive effect if used alongside CNS depressants. Nurses should screen for alcohol use prior to administration of CNS depressants.
True
A 52-year-old male with a 10-year history of daily alcohol use is admitted for alcohol detox. The provider orders diazepam (Valium) for withdrawal management. After the first standard dose, the patient appears restless, anxious, and continues to tremble.
What is the most likely explanation for why the diazepam is not as effective as expected?
The patient has developed cross-tolerance due to chronic alcohol use. Since both alcohol and diazepam act on GABA-A receptors, the body has become less responsive to GABA stimulation, requiring potentially higher doses
A patient with renal impairment is prescribed diazepam.
What is the nursing consideration for this patient?
In patients with kideny (renal) impairement, this drug should be used cautiously. Diazepam is fast-acting, and impaired renal function can lead to accumulation and toxicity
Jessica, a 33-year old female, is admitted into the hospital complaining of insomnia. Upon assessment, you learn Jessica runs outdoors often to try to tire herself out so she can feel sleepy, but for some reason she just cannot sleep.
You prescribe diazepam for Jessica. Knowing she is an outdoor runner, what should you notify her about this drug?
Tell Jessica that diazepam may cause photosensitivity and may cause sunburn/rashes.
What is the pharmacologic class and therapeutic class for the drug: barbital
Pharmacologic Class
- Barbituates
Therapeutic Class
- Sedative-hypnotic
What are common endings for drugs that are barbituates?
- barbital
What is the MOA for barbital?
- Bind to allosteric site on GABA-A receptor (Cl- ion channel in CNS) and cause prolonged opening of channel
- Influx of Cl- ions from ECM
- Cell becomes more negative (hyperpolarization)
- Cell less likely to create action potential = CNS depressant
dizepam and barbital work very similarly. What are the indications in which you would give barbital?
Both drugs are used for insomnia and alcohol withdrawl, but barbitals main indication is for sedation
Indications (summary) of barbital
- insomnia
- alcohol withdrawl
- sedation
What are the therapeutic effects of barbital?
- promote sleep
- induce anthesia
Patients on barbital should be warned of what side effects?
Side Effect:
- Hallucinations
- Lack of coordination
- Slurred speech
A patient is diagnosed with mild anxiety and has a history of addiction. Would barbital or diazepam be the safer choice of drug for this patient?
diazepam is the safer drug choice
barbiturates has a high potential for dependency and can cause physical and pscyhologic dependence. barbiturates are classified as a schedule II substance.
Patients on barbital should be warned of what adverse effects?
Adverse effects
- Respiratory depression
- Hypotention
- Stimulate liver enzymes (may affect metabolism of other drugs)
