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17 Cards in this Set
- Front
- Back
CNS depressants that reduce anxiety, excitability, nervousness without inducing sleep
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Sedatives
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induce and maintain sleep
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Hypnotics
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Depress CNS activity and inhibit stimulation of the brain
Bind with BZ-receptor sites-amplify the the inhibitory effects of gamma aminobutyric acid (GABA) Primary inhibitory neurotransmitter Inhibit stimulation of the brain, calming effect on CNS Facilitate sleep Induces skeletal muscle relaxation |
Benzodiazepines
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Commonly prescribed Benzodiazepines
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Alprazolam (xanax)* most commonly prescribed anxiolytic
Diazepan (Valium) May be used for Moderate/Conscious sedation Lorazepam (Ativan) Cholodiazepoxide (Librium) Midazolam (Versed) Moderate/Conscious sedation |
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commonly used for procedural sedation
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Midazolam (Versed)
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Secreted from the pineal gland during darkness;
indirectly feeds back to the SCN Rhythm setting function |
Melatonin
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decreases activity of the RAS thereby inducing and
sustaining sleep |
Serotonin
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required for REM sleep
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Acetylcholine & norepinephrine
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Released from the “command and control center” for sleep in the hypothalmus
Role: Initiation and maintenance |
GABA (inhibitory amino acid)
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_____ Is an active Process involving the reticular activating system (RAS) and a dynamic interaction of neurotransmitters
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sleep
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insomnia is a ____ not a ______
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symptom not a disease
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Preferred hypnotics
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non-benzodiazepine's such as
ambien, sonata, lunesta |
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Binds specifically to the Omega-1 GABA receptors
5-10 mg po Immediate release, extended release, disintegrating release Intended for short term use Decreases sleep latency and # of a night-time awakenings, improves overall quality of sleep Admin just before bedtime Onset: 5-30 mins Duration 6-8 hrs Half-life 1.5-4hrs |
Zolpidem (Ambien)
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SE of Ambien
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Nausea, diarrhea, dizziness, daytime drowsiness, confusion, sleep- walking, driving, eating, amnesia
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Ramelteon (Rozerem)
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melatonin receptor agonist
Not a scheduled controlled drug Directly stimulates the melatonin receptors involved with sleep Use cautiously in patients with endocrine disorders ✓ testosterone, cortisol, prolactin levels Fast onset, short half-life Decreases sleep latency Not effective in maintenance of sleep |
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For acute reversal of ____ use:
flumazenil (romazicon) Competes with BZ-receptor binding sites |
benzodiazapine overdose (toxicity)
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Benozidiazepines are contraindicated in
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Substance abuse
Pregnancy Category D/breastfeeding Sleep apnea, respiratory depression Use cautiously in patients with renal and liver disease |