CNS Depressants

Question 1

Sedatives

Answer 1

Drugs that have an inhibitory effect on the CNS to the degree that they reduce nervousness, excitability, and/or irritability
Low doses calm the CNS
High doses cause sleep

Question 2

Hypnotics

Answer 2

Cause sleep
Much more potent effect on CNS than sedatives
Sedative can be a hypnotic if given in large enough doses

Question 3

Three Groups of CNS Depressants

Answer 3

Barbiturates
Benzodiazepines
Miscellaneous drugs

Question 4

Benzodiazepines

Answer 4

Sedative-hypnotic and an anxiolytic
Depress CNS activity
Affects hypothalamic, thalamic, and limbic systems
GABA receptors

Question 5

Diazepam (Valium)

Answer 5

Long acting benzodiazepine

Question 6

Lorazepam (Ativan)

Answer 6

Intermediate acting benzodiazepine

Question 7

Midazolam (Versed)

Answer 7

Short acting benzodiazepine

Question 8

Adverse Effects of Benzodiazepines

Answer 8

Fall hazard
“Hangover”
Drowsiness
Headache

Question 9

Indications for Benzodiazepines

Answer 9

Acute seizure disorders
Alcohol withdrawal
Agitation relief
Balanced anesthesia
Moderate or conscious sedation

Question 10

Flumazenil (Romazicon)

Answer 10

Antidote for benzodiazepine toxicity/overdose

Indications are sleepiness, confusion, coma, diminished reflexes

Question 11

Benzodiazepine Interactions

Answer 11

CNS depressants (opioids, alcohol)

Question 12

Eszopiclone (Lunesta)

Answer 12

First hypnotic to be FDA approved for long-term use

Question 13

Barbiturates

Answer 13

Habit forming, low therapeutic index
Affects the brainstem/reticular formation
Not used often anymore except for seizures

Question 14

Indications for Barbiturates

Answer 14

Sedatives
Anticonvulsants
Anesthesia for surgical procedures
PHENOBARBITAL

Question 15

Toxicity and Overdose of Barbiturates

Answer 15

Leads to respiratory depression and CNS depression
No real antidote
Uncontrollable seizures: “phenobarbital coma”
SYMPTOMATIC AND SUPPORTIVE TREATMENT
MAINTAIN ADEQUATE AIRWAY

Question 16

Drug Interactions of Barbiturates

Answer 16

Addictive effects (alcohol, benzodiazepines, opioids)
Inhibited metabolism (MAOIs)
Increased metabolism (reduced anticoagulant response)

Question 17

Muscle Relaxants

Answer 17

Act to relieve pain associated with skeletal muscle spasms
Centrally acting (CNS) or direct acting (skeletal muscle)
Work best when used along with physical therapy

Question 18

Common Muscle Relaxants

Answer 18

Cylobenzaprine (Flexeril)

Carisoprodol (Soma)

Question 19

Adverse Effects of Muscle Relaxants

Answer 19

Euphoria, lightheadedness, dizziness, drowsiness, fatigue, muscle weakness

Question 20

Nursing Implications

Answer 20

Instruct patients to avoid alcohol, obtain vital signs, give hypnotics 30-60 minutes before bedtime, safety measures, monitor for therapeutic effects