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65 Cards in this Set

  • Front
  • Back
what are drugs that have a calming effect on the CNS?
Sedatives and Hypnotics
what are sedatives?
reduce nervousness, excitability, and irritability without causeing sleep, but can become a hypnotic if it is given in large enough doses.
what is a hypnotic
causes sleep. much more potent effect on the CNS.
sedatives-hypnotics
barbiturates, benzodiazepines, and misc drugs.
sleep
decrease in physical activity and consciousness. during sleep a person is no longer aware of sense stimuli.
effects if sedatives-hypnotics on sleep
decrease REM sleep making you tired. after stop using them REM rebound can occur and you can have vivid dreams.
Barbiturates act primarily on what?
brainstem called the reticular formation
Barbiturates act by
reducing the nerve impulses traveling to the area of the brain called the cerebral cortex
GABA
gamma-aminobutyric acic which is found in high concentrations in the CNS.
Barbiturates are capable of raising
seizure thresholds some are udrf in prophylaxis for epileptic seizures
Barbiturates have an effect on the liver and cause
many drugs to be metabolized more quickly.
ultrashort acting Barbiturates
anesthesia for short procedures, control convulsions, narcoanalysis, reduce intracranial pressure in neurosergical pts.
short acting Barbiturates
sedative-hypnotic and control of convulsion conditions
intermediate acting Barbiturates
sedative-hypnotic and control of convulsion conditions
long acting Barbiturates
sedative-hypnotic, epileptic seizure prophylaxis and tx of neonatal hyperbilirubinemia
side effects of Barbiturates
drowsiness, lethargy, dizziness, hangover, and paradoxical restlessness of excitment. alcohol produces side effects.
cardivascular side effects
vasodilation and hypotension
GI side effects
nausea, vomiting, diarrhea, constipation
Hameatological side effects
Agranulocytosis, thrombocytopenia, megaloblastic anemiaq
nervous side effects
drowniness, larthargy, nertigo, HA, mental depression, myalgic, neuralgic, arthralgic pain
respiratory side effects
respiratory depression, apnea, laryngospasm, bronchospasm, coughing
other side effects
Hypersensitivity reactions, urticaria, angioedema, rash, fever, serum sickness, steven-johnson syndrom
steven-johnson syndrome
(SJS) is a severe and potentially life-threatening (15% of cases) disease, it is a hypersensitivity complex affecting the skin and the mucous membranes
what are the characteristics of SJS
fever, sore throat, and headache leading to the sudden development of circular mucocutaneous lesions (target lesions) that can cover the majority of the skin. These lesions begin as macules and can develop into papules, vesicles, bullae, or urticarial plaques. The most extreme cases are termed Toxic Epidermal Necrolysis Syndrome (TENS) or Lyell's Syndrome, in these cases the entire skin is affected.
How do you treat SJS
is initially similar to that of patients with thermal burns, and continued care can only be supportive (e.g. IV fluids) and symptomatic (e.g. analgesic mouth rinse for mouth ulcer); there is no specific drug treatment (2002). An ophthalmologist should be consulted if eyes are involved.
when can intention OD of barbituates be used?
anesthesia and to control seizures
OD of barbituates can produce
coma and death
S/S of OD barbituates
cold and clammy skin, hypothermic, fever, areflexia, tachycardia, and hypotension, pupils constricted
TX of OD barbituates
symptomatic and supportive, make sure aduquate airway NG tube with activated charcoal, alkalication of urine will help too.
don't give barbituates with these...
MAOI's, anticoagulants, oral contraceptives
Butalan-butabarbital
intermediate acting, preop sedative schedule III
nembutal-pentobarbital
insomnia, preop to reduce anxiety and provide sedation, control epilepticus or acute seizures, treat withdrawl of barbituates and hypnotics category D schedule II
Luminal-phenobarbital
long acting, prevention of tonic clonic seizures and fever-induced convulsions, tx of hyperbilirubinemia in neonates and Gilbert's syndrome
Benzodiazepines
are the most commonly perscribed sedative-hypnotic, they produce sedation or sleep
anxiolytic
relieves anxiety
how to Benzodiazepines work
depress the hypothalamic, thalamic, adn limbic systems of the CNS.
Benzodiazepines are different for barbituates by
don't affect REM sleep, don't induce hepatic microsomal enzyme activity.
what do Benzodiazepines do
control agiation and anxiety, adn reduces sensory stimuli, induces sleep, relaxed skeletal muscle, use to treat withdrawl from alcohol
common side effects
HA, drowiness, paradoxialexcitment or nervousness, dizziness or vertigo, cognitive impairment, and lethargy. also create fall hazards
less common side effects
palpitations, dry mouth, vomiting, hypokinesia, and occasional nightmares
S/S of OD
somnolence, confusion, hypokinesia, and nightmares, hypotension and respiratory depression
TX of OD
syrup of ipecac, gastric lavage, activated charcoal

*Flumazenil
don't take Benzodiazepines with
kava kava, grapefruit or grapefruit juice
Prosom-estazolam
short acting adults- 1-2mg elderly 0.5mg
dalmane-flurazepam
long-acting 15-30mgs cause hangover effect category X
doral-quazepam
long-acting 7.5-15mg category X
restoril-temazepam
short acting, adult 15-30mg elderly 7.5 mg catergory X
Halcion - trazolam
short acting adult .25-.5mg elderly .125-.25mg catergory X
Sonata- Zaleplon
short acting don't take more than 10 days due to dependancy short half life category C adult 10mg elderly 5mg
Ambiem-zolpidem
short acting limit 7-10 day tx less hangover feel catergory B adult 10mg elderly 5mg
what do muscle relaxants do
work with the CNS to relieve pain associated with skeletal muscle spasms
what is the only muscle relaxants to work directly on the skeletal muscle
dantrolene
What do the other muscle relaxants effect
enchance GABA central inhibitory effects at eh spinal cord
what parts of the brain do muscle relaxants effect
brainstem, thalamus, basal ganglia
what is muscle relaxants used for
management of multiple sclerosis, cerebral lesions. cerebral palsy, rheumatic disorders, huntington's chorea, parkinsons, trigeminal neuralgia

*use with PT
normal side effects muscle relaxants
euphoria, lightheadedness, dixxiness, drowiness, fatigue, and muscle weakness
less common side effects of muscle relaxants
diarrhea, GI upset, HA,slurred speach, dizziness, muscle stiffness, constipation, sexual difficulties in males, hypetension, tachycardia,and weight gain
Side effect of Dantrolene
hepatotoxicity
TX of muscle relaxants OD
gastric lavage, EEG need to be ran, large amount of IV fluids
interactions with muscle relaxants
alcohol may cause mental confusion, anxiety, tremors, and hypoglycemic activity.
Lioresal-baclofen
central acting 10-20mg tabs and injectables category C
Flexeril-cyclobenzaprine
central acting 10mg dose catergory B
dantrium-danteolene
direct acting 25,50,100 mg tab and 20mg injection can be use to treat mild hyperthermia catergory c
skelaxin-mataxalon
central acting acute pain spasticity
zanaflex-tizanidine
central acting