SEDATIVE HYPNOTICS Flashcards by Rosemary Haas

main reason for being prescribed a sedative hypnotic

**insomnia

anxiety

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what is the clinical definition of insomnia

difficulty sleeping or staying asleep for 3 weeks-month
or
takes longer than 30 min to fall asleep

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the drug of choice for short term insomnia

benzodiazepines

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prototype benzodiazepines

lorazepam (ativan)

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if a drug ends in pam it is a

benzodiazepine

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are benzodiazepines given long term, yes or no

no - 3 weeks to a month max.

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benzodiazepines are given short term, why?

CNS depressant (respiratory)
highly addictive
increased tolerance

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most addictive benzo

Xanax

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why is Xanax the most addictive

works quickly

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5 benzos, what are they

ativan
xanax
valium
klonopin
restoril

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how can benzos be taken

PO, IV, IM

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small dose benzos are given to treat

anxiety

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larger dosed benzos are given to treat

insomnia

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therapeutic uses for benzos

muscle spasms
seizure disorders
alcohol withdrawal

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why are benzos given for seizures

decreases electrical impulses in the brain, provides rest/relaxation

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MOA of benzos

binds to GABA receptors in brain - rest/relaxation
amplifies/intensifies GABA effect
cross blood-brain barrier

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when benzos are taken with alcohol what can happen

respiratory depression - hypo-tension -bradycardia

will on benzos you are considered a fall risk, t or f

true

s/e of benzos

decreased coordination
behavioral changes
respiratory depression
cognitive impairment
teratogenic
elderly considerations (effects x10, effects last longer)

abuse potential for benzos can be seen after

10 doses

why is there an abuse potential with benzos

reducing anxiety (calming aura)
intensifying effects of GABA

*withdrawal symptoms of benzos

seizures - prolonged/life threatening

drug interactions with benzos

alcohol, opiods, barbiturates

tagamet interaction

***overdose on benzo s/s

lethargy
confusion
cardio/resp depression

***reversal for suspected iv benzo overdose

***romazicon (iv push) - repeated until drug clears system

**reversal for suspected PO benzo overdose

**emetic - gastric lavage

barbiturates are given via these routes

PO - IM- IV

barbiturates are given for

prevent seizures - medically induced coma | OR as part of anesthesia

what are barbiturates

powerful CNS depressant | mimics GABA

overdose is common w/barbiturates, t or f

true

benzos are safer than barbiturates, t or f

true

why are benzos safer than barbiturates

increased tolerance | very strong effect on GABA

s/e of barbiturates

hyper-sensitivity to pain respiratory depressant (lethal) less response to pain mgmt w/opiods

reversal for suspected/confirmed barbiturate overdose

none - supportive care (warming blanket, oxygen)

most common benzo-diazepine like drug

ambien

benzo-diazepine like drug route of administration

MOA for ambien

intensifies effect of GABA but only works on 1 type of receptor induces sleep

is ambien ever prescribed for anxiety

no - induces sleep - hypnotic effect

s/e of ambien

sleep walking | no recollection

most common OTC med for insomnia

antihistamines: benadryl - diphenhydramine | melatonin

with insomnia there is always an underlying cause t or f

true