Ch 12 CNS depressants Power Point

Hypnotics

*Cause sleep •Much more potent effect on CNS than sedatives •A sedative can become a hypnotic if it is given in large enough doses.

The patient tells the nurse that his friend has been taking valerian for a long period of time and that he isn't feeling so well. The patient asks the nurse what the adverse effects of valerian are. 2. What adverse effect with valerian would the nurse discuss with the patient? A.Insomnia B.Yellow skin C.Bruising D.Increased appetite

A Adverse effects of valerian include CNS depression, hepatotoxicity, nausea, vomiting, anorexia, headache, restlessness, and insomnia.

Which statement regarding muscle relaxants does the nurse identify as being accurate? A.Baclofen (Lioresal) is available as an injectable form for use with an implantable pump device. B.Cyclobenzaprine (Flexeril) produces little sedation. C.Patients taking muscle relaxants are at high risk of developing hypertension. D.Patients taking muscle relaxants should be told to stop taking the medication if they feel sleepy.

A Baclofen (Lioresal) is sometimes used in an injectable form. Cyclobenzaprine (Flexeril) often results in deep sedation and sleepiness. Patients taking muscle relaxants are at risk to develop hypotension; therefore, they should be taught safety measures to prevent falls. Sedation and sleepiness are common side effects of muscle relaxants; however, a patient should not abruptly discontinue use of the medication. Safety procedures should be followed to prevent accidents and falls.

When providing education to the patient on the use of a benzodiazepine medication, the nurse will include which information? A.These medications have little effect on the normal sleep cycle. B.Using this medication may cause drowsiness the next day. C.It is safe to drive while taking this medication. D.These drugs are safe to use with alcohol.

B. Benzodiazepines interfere with REM sleep and may cause a "hangover" effect or next-day drowsiness. They should not be used with alcohol, and persons taking these drugs should not drive.

An older adult patient taking multiple medications has a barbiturate added to his medication regimen. When administering a barbiturate to an older adult, what should the nurse expect? A.A decrease in dosages of the other medications B.The patient will experience increased amounts of REM sleep C.To administer half of the usual dose of the barbiturate D.Total relief of anxiety

C. Barbiturates are associated with an increased incidence of falls when used in older adults; therefore, the usual dose is reduced by half whenever possible. Because barbiturates stimulate the action of enzymes in the liver, drugs are usually broken down more quickly, sometimes requiring the dose to be increased. Patients taking barbiturates have decreased amounts of REM sleep and often experience paradoxical restlessness or excitement.

The patient asks, "Is there anything I have to worry about when taking Kava?" The best response by the nurse is: A."Kava is a natural product which has no side effects." B."You need a prescription to take Kava." C."No worries, Kava is recommended for patients with depression." D."It is best to inform your health care provider of any additional medication or supplements you plan to take to check for interactions that may be harmful."

D Even natural products have side effects. Side effects of Kava include skin discoloration, possible accommodative disturbances and pupillary enlargement, and scaly skin (with long-term use). Kava and other supplements are available without a prescription. Kava is contraindicated in patients with Parkinson's disease, liver disease, depression, or alcoholism; in those operating heavy machinery; and in pregnant and breastfeeding women. As with all medications and supplements, it is best to inform the health care provider to evaluate possible interactions among drugs and supplements taken.

Barbiturates have a low therapeutic index. How does the nurse interpret this? A.Low doses are not therapeutic. B.The toxic range is narrow. C.They are habit forming. D.The effective, safe dosage range is narrow.

D. Drugs with a low therapeutic index have only a narrow dosage range within which the drug is effective; above that range, they are rapidly toxic. Barbiturates are habit forming, but this is not related to the therapeutic index.

Sedative-hypnotics are classified into three main groups:

➢Barbiturates ➢Benzodiazepines ➢Miscellaneous drugs

Sedatives are drugs that have an inhibitory effect on the CNS to the degree that they reduce:

➢Nervousness ➢Excitability ➢Irritability