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22 Cards in this Set
- Front
- Back
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Reduce anxiety and excitement, minor tranquilizers |
Sedatives
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Produce drowsiness, facilitate sleep (easily aroused)
Also used as anticonvulsants, muscle relaxants, induction of anesthesia |
Hypnotics
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Benzodiazepines - all similar in structure and function, schedule IV drugs
Action, uses, adverse, interactions, nursing |
Increase inhibitory effect of GABA
Action on CNS: sedation, anti-anxiety, anticonvulsant, muscle relaxation, anesthetic effect (no analgesia, anterograde amnesia) Adverse: lightheaded, drowsy, ataxia, incoordination, confusion/amnesia, nightmares, paradoxical reactions, hangover, dependence Interacts w/ any other CNS depressant (ETOH) Monitor for therapeutics, teach about combo, hangover, assess for suicide potential and dependence |
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Diazepam (Valium)
Alprazolam (Xanax) Lorazepam (Ativan) |
Benzodiazepines
Uses: sedation, anti-anxiety, anticonvulsant, muscle relaxation, anesthetic effect (no analgesia, anterograde amnesia) Adverse: CNS Monitor, teach about combo, hangover, dependence |
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Midazolam (Versed)
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Short acting benzodiaxepine
rapid onset, IV or PO liquid (peds) for procedural sedation |
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Flumazenil (Romazicon)
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Benzodiazepine reversal agent
treat OD, reverse sedation and central effects adverse: dizzy, n/v, anxiety, agitation, withdrawal if dependent, seizures, fast onset, short duration, re-dose as needed, MONITOR |
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Barbiturates
what, use, adverse, interactions, nursing |
Older class, BNZs are better option
Low sensitivity (affects all CNS tissue), massive depressant (GABA and RAS system), narrow therapeutic range Use: sedative, hypnotic, anticonvulsants, anesthetic induction Adverse: antianalgesic, resp dep., card dep. (hypotension), increase liver enzymes, hangover common, paradoxical excitement, hypersensitivity Overdose: no reversal agent, hard to manage Interactions: any CNS depressant (ETOH) Contraindicated in COPD or genetic porphyria Abuse: HIGH risk, dependence Taper SLOW (2-3 weeks), risk of status epilepticus Nursing: not common, monitor, teach |
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Phenobarbital (Luminal)
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Barbituate
occasionally used as anticonvulsant or medically induced coma |
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Buspirone (Buspar)
what, use, adverse |
Non-BZD antianxiety, doesn't bind w/ BZD receptor, high affinity for serotonin receptor, some dopamine. Little sedation, no evidence of abuse/tolerance, no withrdawal
Use: long term anti-anxiety (should be short term?) Adverse: dizzy, HA, n/v, dry mouth, caution w/ MAOIs and antipsychotics |
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Zolpidem (Ambien)
Zaleplon (Sonata) what, use, adverse |
Non-BZD hypnotics, binds to BZD receptor, similar effects but no muscle relaxant or anti-convulsant action, little hangover
For insomnia Tolerance, withdrawal, rebound insomnia, amnesia! |
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Eszopicone (Lunesta)
what, use, adverse |
Non-BZD hypnotic, unknown mech, GABA receptors?
Fast onset, short half life For Insomnia Tolerance, withdrawal, rebound insomnia, amnesia! |
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Propofol (Diprovan)
what, use, adverse, association |
Sedative, anesthesia adjunct, unknown mech, rapid onset and rapid recovery (on-off switch)
Use: for sedation in short procedures, with anesthesia and mechanical vent Adverse: apnea, brady, hypotension, requires close monitoring, burns IV (warn, dilute, slow), soy in solution (allergy) Abuse form anesthesiologists, providers. What killed Michael Jackson |
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Oral contraceptive, symptom control of menopause, dysmenorrhea, endometriosis, ovarian development failure, hirsutism, prostatic CA tumor suppression, prevention of osteoporosis and colorectal CA
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uses of estrogens, often in combo w/ progestins
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Estrogen therapy from Women's Health Initiative Study
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Weight risks/benefits. Lowest dose possible for shortest time possible. Not more than 5yrs. Do not use w/ hx of thromboembolie or heart disease
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Oral contraceptives, dysfunctional uterine bleeding, dysmenorrhea, luteal phase defect (early miscarriage, infertility), PMS/PMDD, endometriosis, endometrial CA, treat anorexia or wasting w/ AIDS, CA
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uses of progesterone/progestins, often in combo w/ estrogens
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Mechanism of action of Oral Contraceptives
Teaching |
Reduce FSH & LH via negative feedback, thicken cervical mucus, decrease uterine and tubal motility, inhibits ovulation
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Depro-provera (Medroxyprogesterone)
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progesterone injection
3 month coverage, onset in ~5 days must return every 3 months for injection! |
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Norplant (Levonergestrel)
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progestin subQ implant in upper arm
5 year coverage, onset ~24 hours |
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"Plan B" (Levonorgestrel)
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Post coital emergency contraception, 2 doses of Mini-pill (Levonorgestrel), in first 72 hours after sex
~80% effective |
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Hormone replacement, hypogonadism, castration, short stature (not pituitary), breast CA, anabolism (efficacy?), anemia
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uses of testosterone
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Anabolic steroids - androgenic
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increase N balance, build muscle mass. Research does NOT show increase in strength or performance, lots of adverse effects.
Teach balanced info from source that young athletes will listen to |
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Finasteride (Proscar)
Avodart What, use, considerations, adverse |
5-alpha reductase inhibitor, suppress androgens
Reduce size of prostate in BPH Women of childbearing age should not handle! slow results, decreased libido, ED |
