Drug Class - Sedative/hypnotics

Front 1

Name 3 groups of sedative/hypnotics?

Back 1

barbiturates
benzodiazepines
miscellaneous

Front 2

Name 1 barbituate?

Back 2

phenobarbital

Front 3

Name 9 benzodiazepines?

Back 3

chlordiazepoxide
clorazepate
diazepam
flurazepam
lorazepam
midazolam
oxazepam
temazepam
triazolam

Front 4

Name 7 miscellaneous sedative/hypnotics?

Back 4

droperidol
promethazine
chloral hydrate
dexmedetomidine
hydroxyzine
zaleplon
zolpidem

Front 5

Sedatives are used to provide _____, usually prior to procedures.

Back 5

sedation

Front 6

Hypnotics are used to manage ______.

Back 6

insomnia

Front 7

Selected agents are useful as? (5)

Back 7

anticonvulsants
(clorazepate, diazepam,
phenobarbital)
skeletal muscle relaxants
(diazepam)
adjuncts in the management of
alcohol withdrawal
syndrome
(chlordiazepoxide,
diazepam, oxazepam)
as adjuncts in general
anesthesia (droperidol)
adjuncts in amnestics
(midazolam, diazepam)

Front 8

Sedative/hypnotics cause generalized CNS _______. May produce tolerance with chronic use and have potential for psychological or physical dependence. These agents have ___ analgesic properties.

Back 8

depression
NO

Front 9

Contraindications?
Hypersensitivity. Avoid using during pregnancy or lactation. Should not be used in ____ patients nor in those with pre-existing CNS depression.

Back 9

comatose

Front 10

Contraindications?
Should not be used in patients with uncontrolled severe _____.

Back 10

pain

Front 11

Precautions?
Use cautiously in patients with _____ dysfunction, severe _____ impairment, or severe underlying _____ disease.

Back 11

hepatic
renal
pulmonary

Front 12

Precautions?
Use with caution in patients who may be _____ or who may have had previous drug addictions.

Back 12

suicidal

Front 13

Precautions?
Hypnotic use should be short-term. Geriatric patients may be more sensitive to ____ depressant effects; dosage reduction may be required.

Back 13

CNS

Front 14

Interactions?
Additive CNS depression with (name 5).

Back 14

alcohol
antihistamines
some antidepressants
opioid analgesics
phenothiazines

Front 15

Interactions?
_____ induce hepatic drug-metabolizing enzymes and can decrease the effectiveness of drugs metabolized by the liver, including oral contraceptives.

Back 15

Barbiturates

Front 16

Interactions?
Should not be used with _____ inhibitors.

Back 16

MAO

Front 17

ASSESSMENT:
Monitor blood pressure, pulse, and respiratory status frequently throughout IV administration. Prolonged high-dose therapy may lead to psychological or physical dependence. Restrict the amount of drug available to patient, esp if patient is depressed, suicidal, or has a history of addiction.

Back 17

okay

Front 18

What are 4 major conditions to ASSESS for when taking sedative/hypnotics?

Back 18

insomnia
seizures
muscle spasms
alcohol withdrawal

Front 19

What is the ASSESSMENT for INSOMNIA?

Back 19

Assess sleep patterns before and periodically throughout course of therapy.

Front 20

What are 3 seizure-related assessments to make when patient is taking sedative/hypnotics?

Back 20

observe and record:
intensity
duration
characteristics of seizure
activity
(institute seizure precautions)

Front 21

What are 3 muscle spasm-related assessments to make before and throughout therapy when patient is taking sedative/hypnotics?

Back 21

assess:
muscle spasms
associated pain
limitation of movement

Front 22

What are 4 alcohol withdrawal-related assessments to make when patient is taking sedative/hypnotics?

Back 22

tremors
agitation
delirium
hallucinations
(protect patient from injury)

Front 23

List 3 potential nursing diagnoses?

Back 23

Sleep pattern disturbed
Injury, risk for (s.e.)
Knowledge, deficient, related
to disease processes and
medication regimen

Front 24

IMPLEMENTATION:
Name four safety implements.

Back 24

1. Supervise ambulation and transfer of patients following administration of hypnotic doses.
2. Remove cigarettes.
3. Side rails should be
raised and call bell within reach at all times.
4. Keep bed in low position.

Front 25

Discuss the importance of preparing the environment for sleep. Name 4 ways.

Back 25

darken room
quiet the room
avoid nicotine
avoid caffeine

If less effective after a few weeks, consult hcp; do not increase dose. Gradual withdrawal may be required may be required to prevent reactions following prolonged therapy.

Front 26

IMPLEMENTATION:
May cause ____ drowsiness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.

Back 26

daytime

Front 27

IMPLEMENTATION:
Advise patient to avoid the use of alcohol and other CNS depressants concurrently with these medications.

Back 27

okay

Front 28

Advise patient to inform hcp if pregnancy is planned or suspected.

Back 28

okay

Front 29

EVALUATION:
Effectiveness of therapy can be demonstrated by? (5)

Back 29

Improvement in sleep patterns...control of seizures....decrease in muscle spasms...decreased tremulousness...more rational ideation when
used for alcohol withdrawal.