MICS
Sedative have the inhibitory effect on CNS to reduce nervousness, excitability and irratability
Hyponotics can cause sleep and have much more potent effect on CNS than sedative
Name the 3 groups of CNS depressant?
Barbuites, benzos and Misc drugs
This muscle relaxant is used IV to treat malignant hyperthermia.
Dantrolene (Dantrium)?
Only muscle relaxant used for this emergency.
These two substances should be avoided with muscle relaxants due to added CNS depression.
benzodiazepines and alcohol
What are the A-B-U-S-E signs of benzodiazepine overdose
Altered mental status, Bradycardia, Unable to walk (ataxia), Slurred speech, Eyes blurred, ↓ respirations
This insomnia medication is approved for long-term use up to 12 months
eszopiclone (Lunesta)
fda approved long term hypnotic
Name one common paradoxical reaction to benzodiazepines.
Agitation, anxiety, or restlessness
Elders are specifcially at risk
What are the two major uses for benzodiazepines besides anxiety and sleep.
seizures and alcohol withdrawa
This drug can produce diff effects at diff doses, use for anxiety(acute short term) insomnia, seizure,etoh withdrawal and preop. some signs and symtoms of over dose is AMS, brady, ataxia, slurred speech and Decreased rr. I have an antidote that starts w F. What drug am i(or class) and whats my antidote?
Benzo(midazolam)
antidote:flumanazil
Ms. L., 48 years old, complains of chronic insomnia. She says she “can’t shut her brain off.”
Her provider prescribes zolpidem (Ambien), a nonbenzodiazepine hypnotic.
Two weeks later, her husband reports that she was found cooking in the kitchen at 2 AM with no memory of it.
This patient’s behavior is a known and serious adverse effect of zolpidem. What is it called?
sleepwalking or other sleep-related behavior
This hypnotic has a BLACK BOX WARNING for sleepwalking and dangerous behaviors.”
zolpidem (Ambien)
risk for sleep relate injury
These drugs bind to GABA receptors and enhance its inhibitory effect
benzodiazepines
-MOA is enhancing GABA activity
What is barbuites used for exactly? and what is its caution for use?
used to treat seizures, IV for gen anesthesia, obselete for most uses
Caution for use since high risk for addication, narrow therapuetic window, risk for overdose, scheduled drug
This barbiturate prototype is high-risk, addictive, and used mainly for seizures
Phenobarbital
Prototype barbiturate, now obsolete except for seizures. Narrow TI
These two disorders are long-term reasons to use muscle relaxants for spasticity.
Multiple sclerosis & cerebral palsy
What class of medications becomes a hypnotic when given in high doses?
Sedative
-Sedatives calm the CNS at low doses and induce sleep at high doses.
This drug is used to treat muscle spasms, directly acts on sketal muscle,works well in conjunction w PT and caution use with other CNS depressants?
Baclofen(liorsal)
Which 3 drug classes both bind to GABA receptor?
Barbuites, benzo, nonbenzo sedative hypnotic
I am used for your long term treatment primarily of insomnia, i am not allowed to be used in elders bc it causes dizzy, lightheaded and ideations.
Eszoplicone(lunesta)
Zolpidiem(ambien) is the short term use
This orexin receptor antagonist promotes sleep by blocking wakefulness signals.
Suvorexant (Belsomra)
This benzodiazepine is commonly used for conscious sedation in procedures
midazolam (Versed)
Used for preprocedural sedation
This drug class includes zolpidem and eszopiclone.”
nonbenzodiazepine sedative-hypnotics
Act at GABA receptor, used for insomnia.
Which drug is used in induction of sleep, se are more common in female, super long 12 hr halflife, can have daytime somnelnce.
Surorexant
^orexin receptor antgonist
Mr. J., 62 years old, is scheduled for a colonoscopy. He has severe anxiety and keeps shaking his leg and hyperventilating. The provider orders midazolam (Versed) IV for procedural sedation.
His wife reports he sometimes gets confused at night and he has a history of alcohol use.
Mr. J suddenly becomes extremely confused and agitated after the medication. What is happening?
paradoxical reactions
Benzodiazepines can cause agitation, restlessness, or increased anxiety especially in older adults.
Sedatives and hypnotics share this dose-dependent relationship.. what is it?
low dose = calm CNS; high dose = sleep