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53 Cards in this Set
- Front
- Back
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During which phase of sleep do individuals experience their most recallable dreams
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REM
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Related to children, they have which stages of sleep more
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stages III (NREM) and stage IV (NREM) as compared to older adults who have decreased stage III and IV and have frequent waking periods.
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What is the mildest form of sedation
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sedatives
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What does sedation do
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diminishes physical and mental responses at lower dosages of certain CNS depressants but does not affect consciousness.
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Why are short-acting hypnotics useful
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because the allow the client to awaken early in the morning without experiencing lingering side effects.
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Why are intermediate-acting hypnotics useful
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Because the SUSTAIN sleep, however, after using one the client may experience residual drowsiness or hangover in the morning.
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What are the common side-effects and adverse reactions of sedative-hypnotics
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hangover
REM-rebound Dependence Tolerance Excessive Depression Respiratory Depression Hypersensitivity |
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When are hypnotics contrainindicated
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pregnancy
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List the categorys of sedative-hypnotics
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barbiturates
benzodiazepines nonbenzodiazepines piperidinediones |
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Barbiturates are classified as what
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long-acting
intermediate-acting short-acting ultrashort-acting |
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Long-acting barbituates include what and are used to tx what
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phenobarbital and mephobarbital
used to control seizures in epilepsy |
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What are the the intermediate-active barbiturates
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amobarbital (Amytal)
aprobarbital (Alurate) butabarbital (Butisol) |
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What are the intermediate-acting barbituates used for
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sleep sustainers form maintaining long periods of sleep. Beause these durges take approximately 1 hour for the onset of sleep, they are not prescribed for those who have trouble getting to sleep.
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When taking intermediate-acting barbituates what should be closely monitored
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vital signs
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What are the short-acting barbiturates
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secobarbital (Seconal) and pentobarbital (Nembutal)
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What are short-acting barbiturates used for
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induce sleep in those who are having difficulty in falling asleep. May cause person to awaken early in the morning. Monitor VS closely.
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Ultrashort-acting barbiturates are
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thiopental sodium (Pentothal)
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Ultrashort-acting barbiturates
used for |
general anesthesia
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What is the time frame that barbiturates should be used for
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2 weeks or less because of their numerous side-effects.
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Controlled substances Acts lists barbiturates as what class
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Class II
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Pentobarbital (Nembutal)is primarily used for what
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sleep induction and for sedation needs.
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What is the onset of Pentobarbital (Nembutal)
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rapid onset with a short duration of action - thus considered a short-acting barbiturate.
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With Pentobarbital (Nembutal) is onset of action faster PO or IM
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PO
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Pentobarbital (Nembutal) decreases the effect of which drugs
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oral anticoagulants
glucocorticoids tricyclic antidepressants quinidine |
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Why are benzodiazepines ordered
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as sedative-hypnotics for inducing sleep
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What are the five benzodiazepines that are marketed as hypnotics
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flurazepam (Dalman)
temazepam (Restoril) triazolam (Halcion) estazolam (ProSom) quazepam (Doral) |
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Increased anxiety might be the cause of insomnia for some clients, if so which drugs might be administered to alleviate these symptoms
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lorazepam (Ativan)
diazepam (Valium) oxazepam (Serax) |
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Lorazepam (Ativan)
diazepam (Valium) oxazepam (Serax) and considered which schedule out of Controlled Substances Act |
IV
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Benzodiazepines can suppress which stage of sleep
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stage IV of NREM
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Benzodiazepines should not be used longer than what and why
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3-4 weeks
to prevent REM rebound |
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Triazolam (Halcion) - short acting
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Is seldom used due to side-effects
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For benzodiazepine overdose, what is prescribed
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benzodiazepine antagonist flumazenil
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Flurazepam is highly protein bound. What does this mean if it is taken with other highly protein-bound drugs
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increases the risk of adverse effects.
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Regarding benzodiazepine what dose should be given to the older adult
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1/2 dose
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What is Flurazepam used for
What is the onset |
to tx insomnia by inducing and sustaining sleep.
It has a rapid onset of action and intermediate-to long-acting effects |
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What is Zolpidem (Ambien)
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a nonbenzodiazepine
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What is Zolpidem (Ambien) used for
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short-term tx of insomnia(<10 days)
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What is the duration of actioin of Zolpidem (Ambien)
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6-8 hours with a short half-life of 2 to 2.5 hours.
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What are Piperidinediones
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have similar effects to short-acting barbiturates.
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What are the adverse effects of Piperidinediones
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vasomotor collapse
serious blood dyscrasias (aplastic anemia) allergic reactions ** over the past decade, the use of the piperidinedione group has declined). |
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What is the purpose of Chloral Hydrate (non-barbiturate)
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to induce sleep and to decrease nocturnal awakenings; id todes not suppress REM sleep.
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What are the benefits of Chloral Hydrate (non-barbiturate)
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There is a less occurrence of hangover, respiratory depression, and tolerance.
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It Chloral hydrate (non-barbiturate) effective in the older adult.
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yes
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You can take Chloral hydrate even if you have
HOWEVER You cannot take Chloral hydrate if you have |
mild liver dysfunction
severe renal disorder |
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Drugs that interact with Chloral hydrate (non-barbiturate) are
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CNS depressants
furosemide oral anticoagulants |
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Barbiturates increase CNS depression and confusion in which client, and should not be given for sleep.
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Older clients
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The best sleep aids for the older adults are
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short-acting to intermediate-acting benzodiazepines such as:
estazolam (ProSom) oxazepam (Serax) temazepam (Restoril) triazolam (Halcion) |
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Older adults should avoid the long-acting hypnotic benzodiazepines such as
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flurazepam (Dalmane
quazepam (Doral) diazepam (Valium) |
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The older adult should be instructed to take benzodiazepines no more than how many times a week to avoid side effects and drug dependency.
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no more than four times a week.
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Regarding sleep - do not take Kava kava with what
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CNS depressants such as barbiturates and opioids. This herb may increase the sedative effect.
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How do you administer Pentobarbital
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IV at a rate of <50 mg/min
IM in a deep muscle such as gluteus medius |
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Can penobarbital be mixed with other medications.
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no
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What are the advanatages of using benzodiazepine hypnotics instead of barbituratres for sleep disorders.
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BENZODIAZOPINES are effective for sleep disorders for several weeks longer than other sedative-hypnotics; however, they shouldl not be used for longer than 3 to 4 weeks as a hypnotic to prevent REM rebound. **CLARE ADD TO THIS LATER***
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