CNS Depressants

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Choose all the statements below that are correct regarding Benzodiazepines. (Select all that apply.)

*Affect the hypothalamic, thalamic, and limbic systems of the brain (GABA receptors)​ *Reduce excessive sensory stimulation which induces sleeps​ *Induce relaxation of skeletal muscles

Select the true statement(s) regarding CNS depressants. (Select all that apply.)

*Alcohol should not be used with these CNS Depressants because the combination multiples the CNS depressive effects. *There is a black box warning regarding the combination of all opioids with all benzodiazepines which can cause serious CNS depression (extreme sleepiness, respiratory depression, coma and death). *There are significant drug-drug interactions with benzodiazepines, especially with other CNS Depressants, due to the intensity of benzodiazepines and the combined CNS depressant effects.

Barbiturates carry with them many contraindications, risk for dependence and overdose, as well as many drug-drug interactions.​ Drag the statements below that apply to barbiturates and drop them to the right side column:

*Contraindicated in pregnancy​ *Barbiturates cause enzyme stimulation in the liver leading to a shortened duration of action of many drugs.​ *Overdose of barbiturates typically leads to respiratory arrest, coma, and death.​ *Pentobarbital (Nembutal) and phenobarbital help to treat insomnia, withdrawal symptoms, and to control status epilepticus.​ *Their long term use can lead to harmful effects on sleep due to the deprivation of REM sleep.

Choose the correct statement(s) below regarding sedative-hypnotics. (Select all that apply.)

*Discontinuation of a sedative-hypnotic can cause REM rebound resulting in too much REM sleep and frequent, vivid dreams. *Prolonged use of sedative-hypnotics can cause REM interference resulting in daytime fatigue​.

Select the true statement below regarding sedative-hypnotics.

*Hypnotics at high doses calm the CNS and cause sleep.

Which of the following statements are true regarding barbiturates? (Select all that apply.)

*The long-term use of barbiturates can lead to harmful effects on sleep due to the deprivation of REM sleep.​ *Overdose of barbiturates typically leads to respiratory arrest, coma, and death.​ *Barbiturates are a type of sedative-hypnotic. *Increased CNS depression occurs when administered with alcohol, antihistamines, benzodiazepines, opioids and tranquilizers. *MAOIs (antidepressants) result in a longer duration of action of barbiturates. ​

1. Intermediate-acting benzodiazepines 2. Long-acting benzodiazepines 3. Short-acting barbiturates 4. Long-acting barbiturates 5. Benzodiazepine most commonly used for preoperative anxiety and for moderate sedation 6. GABA receptor antagonist that is the antidote to benzodiazepines 7. Non-benzodiazepine, a short-acting hypnotic with a relatively low incidence of daytime sleepiness 8. Long-acting benzodiazepine most commonly used to treat for status epilepticus

1. Alprazolam, lorazepam, temazepam 2. Clonazepam, diazepam, flurazepam 3. Pentobarbital, secobarbital, pentobarbital 4. Phenobarbital, mephobarbital, phenobarbital 5. Midazolam 6. Flumazenil 7. Zolpidem 8. Diazepam

1.___________ are the subclass of CNS Depressants which inhibit nerve impulses by acting on the brainstem and GABA receptors resulting in the inhibition of nerve impulses in the cerebral cortex. ​

1. Barbiturates

1. methohexital and thiopental 2. pentobarbital and secobarbital 3. butabarbital 4. phenobarbital and mephobarbital

1. Induction of anesthesia 2. Prevent hyperbilirubinemia in neonates 3. Sedation 4. Prevention of seizures

1.____________ produce a sense of calm, reduce nervousness, excitability, and irritability without causing sleep unless given in a large enough dose. 2._______________ cause sleep with a much more potent CNS effect than 3._____________. 4._______________ can act as either a sedative or a hypnotic depending on the dose and patient responsiveness. In low doses, they calm the CNS without causing sleep. In high doses, they calm the CNS and cause sleep.​

1. Sedatives 2. Hypnotics 3. Sedatives 4. Sedative-Hypnotics

Pentobarbital is a 1.______________ acting 2.___________ now used for preoperative anxiety and to produce 3.______________, to treat symptoms of withdrawal from other barbiturates and nonbarbiturates, control status epilepticus, and to 4.____________ hyperbilirubinemia in neonates.​ Phenobarbital is a 5.______________ acting 6.___________ used to 7.______________ generalized tonic-clonic seizures and fever-induced convulsions, as well as 8.____________ of hyperbilirubinemia in neonates. It is 9._____________ used as a sedative or hypnotic.​

1. Short- 2. Barbiturate 3. Sedative effects 4. Prevent 5. Long- 6. Barbiturate 7. Prevent 8. Treatment 9. No longer

Nonbenzodiazepines act on the CNS 1.____________. Orexin Receptor Antagonists (also called hypocretins) act on the CNS 2.____________. ​

1. and act very much like benzodiazepines​ 2. and act very much like benzodiazepines ​

Central Nervous System (CNS) Depressants are drugs that result in a calming effect by 1._______________ the transmission of nerve impulses to the CNS.

1. inhibiting

Sedative-hypnotics, the group of CNS depressants that have either a sedative or hypnotic effect, or both, depending on various factors, are broken into 3 groups based on their chemical makeup. Which of them carries the highest risk for dependence and are therefore used less?

Barbiturates

Which of the following are currently the more frequently prescribed sedative-hypnotic drugs? ​

Nonbenzodiazepines

Benzodiazepines carry a black box warning regarding what?

The combination of all opioids with all benzodiazepines can cause serious CNS depression (extreme sleepiness, respiratory depression, coma and death).


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