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17 Cards in this Set

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CNS depressants that reduce anxiety, excitability, nervousness without inducing sleep
Sedatives
induce and maintain sleep
Hypnotics
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
Commonly prescribed Benzodiazepines
Alprazolam (xanax)* most commonly prescribed anxiolytic
Diazepan (Valium) May be used for Moderate/Conscious sedation
Lorazepam (Ativan)
Cholodiazepoxide (Librium)
Midazolam (Versed) Moderate/Conscious sedation
commonly used for procedural sedation
Midazolam (Versed)
Secreted from the pineal gland during darkness;
indirectly feeds back to the SCN
Rhythm setting function
Melatonin
decreases activity of the RAS thereby inducing and
sustaining sleep
Serotonin
required for REM sleep
Acetylcholine & norepinephrine
Released from the “command and control center” for sleep in the hypothalmus
Role: Initiation and maintenance
GABA (inhibitory amino acid)
_____ Is an active Process involving the reticular activating system (RAS) and a dynamic interaction of neurotransmitters
sleep
insomnia is a ____ not a ______
symptom not a disease
Preferred hypnotics
non-benzodiazepine's such as
ambien, sonata, lunesta
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)
SE of Ambien
Nausea, diarrhea, dizziness, daytime drowsiness, confusion, sleep- walking, driving, eating, amnesia
Ramelteon (Rozerem)
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
For acute reversal of ____ use:
flumazenil (romazicon)
Competes with BZ-receptor binding sites
benzodiazapine overdose (toxicity)
Benozidiazepines are contraindicated in
Substance abuse
Pregnancy Category D/breastfeeding
Sleep apnea, respiratory depression
Use cautiously in patients with renal and liver disease