Sleep & Hypnotic Rxs

Question 1

What does sleep and hypnotics do to the Central Nervous System?

Answer 1

Depresses

Question 2

What are the two (2) main classes of Rx ?

Answer 2

Benzodiazepines
Benzodiazepine-like drugs

Question 3

Drugs in this category are indicated for what conditions? Think of the SEA & this will help you remember***

Answer 3

Sleep = hypnotics
Ease agitation = sedatives
Anxiety = anxiolytics

Question 4

Anxiety is a what define ?

Answer 4

Disorder characterized by feelings of nervousness, tension and worry
Typically, experienced when a situation is perceived as threatening.

Question 5

What type of anxiety is a response to a stressful situation?

Answer 5

Situational

Question 6

Is situational anxiety, a normal response answer ? Yes or No

Answer 6

Yes

Question 7

What type of anxiety is, severe anxiety that impairs activities of daily living?

Answer 7

Anxiety disorder

Question 8

How would a patient or client look or appear with anxiety?

Answer 8

Motor tension
Overactive autonomic response
Difficulty concentrating
Irritability
Insomnia

Question 9

What class of drugs would be ordered for short-term anxiety?

Answer 9

Benzodiazepines

Question 10

What are the three classes of medication for long-term anxiety?

Answer 10

1) SSRIs Selective serotonin reuptake inhibitors 2)TCAs Tricyclic and tetracyclic antidepressants, 3)SNRIs Serotonin and norepinephrine reuptake inhibitors

Question 11

What percentage of people experience insomnia?

Answer 11

30%

Question 12

Insomnia is defined as an inability to sleep well and can manifest as:
Inability to fall asleep
Inability to stay asleep
Sleep that is refreshing
True or False

Answer 12

False ( key word ** not)

Question 13

What are four (4) factors that can cause insomnia?

Answer 13

1. Medical conditions
2. Psychiatric conditions
3. Stress
4. Suboptimal sleep conditions

Question 14

Think about the management of insomnia, when are medications ordered?

Answer 14

Second-Line

Question 15

How long are Rx’s ordered for in second-line insomnia?

Answer 15

2-3 weeks short duration

Question 16

Which class of drugs are ordered for insomnia?

Answer 16

Benzodiazepines & Benzodiazepine-like drugs

Question 17

Ramelteon is in the class Melatonin receptor agonist, sedative hypnotic - what are important nursing considerations for this drug?

Answer 17

• Not for use in pregnancy or breastfeeding, take 30 minutes before bedtime

Question 18

What is the route of administration?

Answer 18

Oral

Question 19

What is the usual adult dose?

Answer 19

8 mg.

Question 20

What are OTC medications that are used for insomnia?

Answer 20

Melatonin
Antihistamines

Question 21

What is the first-choice medication for short-term anxiety?

Answer 21

Benzodiazepines

Question 22

There are seven Benzodiazepines to learn *** the best way to remember is ** All Cats Dogs Lions Monkeys & Tigers Cry

Answer 22

Alprazolam, Clonazepam, Diazepam, Lorazepam, Midazolam, Temazepam, Chlordiazepoxide

Question 23

What is the action of a Benzodiazepine?

Answer 23

Bind to the gamma-amino-butyric acid (GABA) receptor and potentiate the action of GABA

Question 24

What are the physiologic actions on the respiratory system?

Answer 24

Respiratory depression

Question 25

What are the physiologic actions on the cardiovascular system when using the IV route ?

Answer 25

Hypotension

Question 26

What are the physiologic actions on the central nervous system (CNS) ?

Answer 26

Reduce anxiety, promote sleep, muscle relaxation, confusion, anterograde amnesia (which is an impaired capacity for new learning or new memories

Question 27

What is a drug interaction with c?

Answer 27

Depressants (CNS)

Question 28

What are the conditions or indications for Benzodiazepines?

Answer 28

Anxiety, Insomnia, Seizures, Muscle Spasms, ETOH W/D, & General Anesthesia

Question 29

Why are Benzodiazepines not ordered for a long period of time?

Answer 29

A prolonged use of benzodiazepines can lead to tolerance and dependence

Question 30

Describe the difference between dependence and tolerance to drugs

Answer 30

Dependence happens when a person takes a drug over time and unpleasant physical symptoms occur if the drug is suddenly stopped or taken in smaller doses - on the other hand, is when the body gets use to a medication so that either more medication is needed or a different medication is needed