CNS Depressants and Muscle Relaxants Flashcards Preview

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Flashcards in CNS Depressants and Muscle Relaxants Deck (39):
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Baclofen
(Functional Classification)

Skeletal Muscle Relaxant, Central Acting

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Baclofen
(Chemical Classification)

GABA chlorophenyl derivative

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Baclofen
(Mechanism of Action)

Inhibits synaptic responses in CNS by stimulating GABAb receptor subtype, which decreases neurotransmitter function; decreases frequency, severity of muscles spasms

3

Baclofen
(Uses)

Spasticity with spinal cord injury, multiple sclerosis

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Baclofen
(Contraindications)

Hypersensitivity

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Baclofen
(Side Effects)

CNS: Dizziness, Weakness, Fatigue, Drowsiness, headache, Disorientation, insomnia, paresthesias, tremors; SEIZURES, LIFE-THREATENING CNS DEPRESSION, COMA; CNS INFECTION (IT)
CV: hypotension, chest pain, palpitations, edema, CARDIOVASCULAR COLLAPSE (IT)
EENT: nasal congestion, blurred vision, mydriasis, tinnitus
GI: Nausea, constipation, Vomiting, increased AST, alk phos, abdominal pain, dry mouth, anorexia
GU: urinary frequency, hematuria
INTEG: rash, pruritus
RESP: dyspnea; respiratory failure (IT)

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Baclofen
(Nursing Considerations)

ASSESS:
-MULTIPLE SCLEROSIS: spasms, spasticity, ataxia; improvement should occur with product BP, weight, blood glucose, hepatic function periodically
-SEIZURES: for increased seizure activity with seizure disorders; product decreases seizure threshold; EEG in epileptic patients
-I&O ratio; check for urinary frequency
-Allergic reactions: rash, fever, respiratory distress
-Severe weakness, numbness in extremities
-Tolerance: increased need for medication, more frequent requests for medication, increased pain
-WITHDRAWAL SYMPTOMS: CNS depression, dizziness, drowsiness, psychiatric symptoms
-INTRATHECAL: have emergency equipment nearby; assess test dose and titration; if no response, check pump, catheter for proper function

PERFORM/PROVIDE:
-Assistance with ambulation if dizziness, drowsiness occurs

7

Baclofen
(Overdose Treatment)

Induce emesis of conscious patient, activated charcoal, dialysis, physostigmine to reduce life-threatening CNS side effects

8

Cyclobenzaprine
(Functional Classification)

Skeletal muscle relaxant, central acting

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Cyclobenzaprine
(Chemical Classification)

Tricyclic Amine Salt

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Cyclobenzaprine
(Mechanism of Action)

Reduces tonic muscle activity at the brain stem; may be related to antidepressant effects

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Cyclobenzaprine
(Uses)

Adjunct for relief of muscle spasm and pain in musculoskeletal conditions

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Cyclobenzaprine
(Contraindications)

Children <12yr, acute recovery phase of MI, dysrhythmias, heart block, CHF, hypersensitivity, intermittent porphyria, thyroid disease, QT prolongation

13

Cyclobenzaprine
(Side Effects)

CNS: Dizziness, Weakness, Drowsiness, headache, tremor, depression, insomnia, confusion, paresthesia, nervousness
CV: postural hypotension, tachycardia, DYSRHYTHMIAS
EENT: diplopia, temporary loss of vision
GI: Nausea, vomiting, hiccups, dry mouth, constipation, hepatitis
GU: urinary retention, frequency, change in libido
INTEG: rash, pruritus, fever, facial flushing, sweating

14

Cyclobenzaprine
(Nursing Considerations)

ASSESS:
-PAIN: location, duration, mobility, stiffness at baseline, periodically
-ALLERGIC REACTIONS: rash, fever, respiratory distress
-severe weakness, numbness in extremities

PERFORM/PROVIDE:
-Assistance with ambulation if dizziness, drowsiness occur, especially for geriatric patients

15

Cyclobenzaprine
(Overdose Treatment)

Administer activated charcoal; use anticonvulsants if indicated; monitor cardiac function

16

Temazepam
(Functional Classification)

Sedative/Hypnotic

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Temazepam
(Chemical Classification)

Benzodiazepine, short to intermediate acting

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Temazepam
(Mechanism of Action)

Produces CNS depression at limbic, thalamic, hypothalamic levels of the CNS; may be mediated by neurotransmitter gamma aminobutyric acid (GABA); results are sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, anxiolytic action

19

Temazepam
(Uses)

Insomnia

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Temazepam
(Contraindications)

Pregnancy (X), breastfeeding, hypersensitivity to benzodiazepines, intermittent porphyria

21

Temazepam
(Side Effects)

CNS: Lethargy, Drowsiness, Daytime Sedation, dizziness, confusion, light-headedness, headache, anxiety, irritability, complex sleep-related reactions (sleep-driving, sleep eating), fatigue
CV: chest pain, pulse changes, hypotension
EENT: blurred vision
GI: nausea, vomiting, diarrhea, heartburn, abdominal pain, constipation, anorexia
SYST: SEVERE ALLERGIC REACTIONS

22

Temazepam
(Nursing Considerations)

ASSESS:
- Mental status: mood, sensorium, affect, memory (long, short)
-Type of sleep problem: falling asleep, staying asleep
-DEPENDENCY: restrict amount given to patient, assess for physical/psychological dependency; high-level risk for abuse

PERFORM/PROVIDE:
-Assistance with ambulation after receiving dose
-Safety measures: night-light, call bell within easy reach
-Checking to confirm that PO medication has been swallowed

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Temazepam
(Overdose Treatment)

Lavage, activated charcoal; monitor electrolytes, VS

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Zaleplon
(Functional Classification)

Sedative/Hypnotic, Nonbarbiturate

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Zaleplon
(Chemical Classification)

Pyrazolpyrimidine

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Zaleplon
(Mechanism of Action)

Binds selectively to omega-1 receptor of the GABA(A) receptor complex; results are sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, anxiolytic action

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Zaleplon
(Uses)

Insomnia

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Zaleplon
(Contraindications)

Hypersensitivity, Severe Hepatic Disease

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Zaleplon
(Side Effects)

CNS: Lethargy, Drowsiness, Daytime Sedation, dizziness, confusion, anxiety, amnesia, depersonalization, hallucinations, hyperesthesia, paresthesia, somnolence, tremor, vertigo, complex sleep related reactions: sleep driving, sleep eating
EENT: vision change, ear/eye pain, hyperacusis, parosmia
GI: nausea, abdominal pain, constipation, anorexia, colitis, dyspepsia, dry mouth
MISC: asthenia, fever, headache, myalgia, dysmenorrhea
SYST: SEVERE ALLERGIC REACTIONS

30

Zaleplon
(Nursing Considerations)

ASSESS:
-Mental Status: mood, sensorium, affect, memory (long, short term) excessive sedation, impaired coordination
-SLEEP DISORDER: type of sleep problem: falling asleep, staying asleep

PERFORM/PROVIDE:
-Assistance with ambulation
-Safety measure: night-light, call bell within easy reach
-Check to see if PO medication has been swallowed

31

Zolpidem (Ambien)
(Functional Classification)

Sedative/Hypnotic

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Zolpidem (Ambien)
(Chemical Classification)

Imidazopyridine

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Zolpidem (Ambien)
(Mechanism of Action)

Produces CNS depression at limbic, thalamic, hypothalamic levels of CNS; may be mediated by neurotransmitter gamma aminobutyric acid (GABA); results are sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activitym anxiolytic action

34

Zolpidem (Ambien)
(Uses)

Insomnia, short-term treatment; insomnia with difficulty of sleep onselt/maintenance (ext rel)

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Zolpidem (Ambien)
(Contraindications)

Hypersensitivity to benzodiazepines

36

Zolpidem (Ambien)
(Side Effects)

CNS: headache, lethargy, drowsiness, daytime sedation, dizziness, confusion, lightheadedness, anxiety, irritability, amnesia, poor coordination, complex sleep-related reactions (sleep driving, sleep eating), depression, somnolence, SUICIDAL IDEATION, abnormal thinking/behavior changes
CV: chest pain, palpitations
GI: nausea, vomiting, diarrhea, heartburn, abdominal pain, constipation
HEMA: LEUKOPENIA, GRANULOCYTOPENIA (rare)
MISC: myalgia
SYST: SEVERE ALLERGIC REACTIONS

37

Zolpidem (Ambiem)
(Nursing Considerations)

ASSESS:
-Mental Status: mood, sensorium, affect, memory (long, short term), excessive sedation, impaired coordination, SUICIDAL THOUGHTS/BEHAVIORS
-Blood dyscrasias: fever, sore, throat, bruising, rash, jaundice, epistaxis (rare)
-Type of sleep problem: falling asleep, staying asleep

PERFORM/PROVIDE:
-Assistance with ambulation after receiving dose

38

Zolpidem (Ambien)
(Overdose Treatment)

Lavage, activated charcoal; monitor electrolytes, VS