Prepare: CNS Depressants

CNS Depressants

Subclass of CNS Depressants

Black Box Warning

• Benzodiazepines carry a black box warning regarding what?

Self-Check: CNS Depressant

CNS Depressant

• Choose the correct CNS Depressant (sedatives, hypnotics, or sedative-hypnotic) based on the degree to which it causes the inhibition of nerve impulses in the CNS.

Self-Check: Sedative-hypnotics

Sedative-hypnotics

• 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?

Self-Check: Barbiturates: Safety Considerations

• Barbiturates: Safety Considerations
• 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:

Self-Check: Benzodiazepines

Benzodiazepines

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

Self-Check: Nonbenzodiazepines and Orexin Receptor Antagonists

• Nonbenzodiazepines and Orexin Receptor Antagonists

Reflect: CNS Depressant

• CNS Depressants

Sedative-hypnotics

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

Sedative-hypnotic Drugs

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

CNS Depressants

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

Barbiturates

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

Sedative-hypnotics

• Select the true statement below regarding sedative-hypnotics.

Barbiturates

• Match each barbiturate drug to its common use.

Sedative-hypnotics

• Match the sedative-hypnotic CNS Depressant medication to its subclass.

IF CAN’T READ

• Intermediate-acting benzodiazepines
• Long-acting benzodiazepines
• Short-acting barbiturates
• Long-acting barbiturates
• GABA receptor antagonist that is the antidote to benzodiazepines
• Long-acting benzodiazepine most commonly used to treat for status epilepticus
• benzodiazepine most commonly used for preoperative anxiety and for moderate sedation
• Non-benzodiazepine, a short-acting hypnotic with a relatively low incidence of daytime sleepiness

Intermediate Acting Benzodiazepines (alprazolam)

Prepare: Intermediate Acting Benzodiazepines (alprazolam)

• Which of these medications is an intermediate-acting benzodiazepines used for its anxiolytic effects?
• Benzodiazepines are contraindicated in pregnancy and lactation because they: (Select all that apply.)
• Benzodiazepines are most often used for which of these effects?

Self-Check: Intermediate Acting Benzodiazepines

• Intermediate-acting benzodiazepines are so called because:
• Benzodiazepines

Self-Check: alprazolam

• Which of these are indications for the use of alprazolam? (Select all that apply.)

Reflect: Intermediate Acting Benzodiazepines (alprazolam)

alprazolam: Indications for Use

• Identify the applicable indications for the use of alprazolam:

alprazolam

• In administering alprazolam to a client with COPD which of the following is a concern?

CNS Depressants and Drug Interactions

• Which of the following items have CNS depressive effects and should be used with caution in patients taking alprazolam? (Select all that apply.)

Dosage of alprazolam

• How might the dosage of alprazolam be adjusted in an elderly patient and why?
• Nicotine

alprazolam: Classifications

• Which of the following characteristics describe alprazolam?

Benzodiazepines

• Which of the following is the most accurate statement related to the increased risk for dependence and addiction when benzodiazepines (such as Xanax) are taken with other CNS Depressants?

CNS Depressant

• A patient taking alprazolam, or any CNS Depressant, should avoid which of the following? (Select all that apply.)

Nursing Application: CNS Depressants

Prepare: Nursing Application: CNS Depressants

• Nursing Assessment
• pentobarbital: Indications
• Risks of CNS Depressants

Self-Check: Nursing Assessment

Nursing Assessment

• As the nurse caring for a patient taking a CNS Depressant. Which adverse effect does the nurse need to consider when assessing a client prescribed a CNS depressant?
• Patient Education

Self-Check: Nursing Assessment: Specific Medications

• Barbiturates

Self-Check: Nursing Interventions

Nursing Interventions

• As the nurse caring for the patient taking a CNS Depressant, you are planning nursing interventions used to minimize some of the risks associated with this drug class, such as:
• (Select all that apply.)

Reflect: Nursing Application: CNS Depressants

Nursing Assessment

• In reviewing benzodiazepine use in an elderly client, you anticipate: (Select all that apply.)

Nursing Interventions

• You are the nurse caring for a 24-year-old patient who is recovering from a surgical procedure. He has recently been admitted to your unit from the post-anesthesia care unit and is recovering well and is tolerating drinking liquids. You were told in a report that he received diazepam for sedation during the procedure as an adjunct anesthetic to aid in intubation. You enter the room to check his vital signs and notice that his mom is handing him a drink she brought from home and notice that it is grapefruit juice.
• Based on your knowledge of this interaction, your first action is to:

Patient Teaching

• Nursing Interventions

Priority of Assessment

• You are caring for a patient taking a CNS Depressant. You are considering your plan of care for this patient based on the subjective and objective data you have collected, as well as your knowledge of this drug class. You choose the following as the priority focus for your nursing care:

Patient Education

• You are the nurse caring for Steven, a 72-year-old male who is being discharged home. He has been prescribed a barbiturate to treat seizures. His medical record indicates that he suffers from seasonal allergies for which he takes over-the-counter medication, drinks alcoholic beverages on occasion, and has a history of Deep Vein Thrombosis (DVTs) and depression. You discuss with the patient the adverse effects that may result in particular when taken with other CNS depressive substances.
• Which of the following statements do you include in your patient's education regarding barbiturates in regard to his particular medical history?

Contraindications

• You are the nurse caring for Ed, a 51-year-old man with a history of hypertension, glaucoma, and Deep Vein Thrombosis (DVTs). He has been prescribed a benzodiazepine. Based on your knowledge of Ed’s medical history, this drug class and its possible contraindications and drug-drug interactions, you know that:

(Select all that apply.)

CNS Depressant Safety Considerations

• The nurse is preparing discharge instructions for a client being sent home with a prescription for a benzodiazepine. Match the following instructions to the potential risks of this medication class.

Muscle Relaxants

Prepare: Muscle Relaxants

Muscle relaxants are categorized by their____________.

Muscle Relaxants: Indications for Use

Muscle relaxants and other CNS Depressants have _____ indications for use including insomnia and sedation.

Abused Drug

_______ has become a commonly abused drug, in particular in combination with an opioid and a benzodiazepine.

Self-Check: Muscle Relaxants

Muscle Relaxants

• Most muscle relaxants work on the CNS and . (Select all that apply.)

Muscle Relaxants

• Muscle relaxants are found to be the most effective when combined with ______.

Self-Check: Safety Considerations

Muscle Relaxant Overdose

• The reversal drug for muscle relaxant overdose is which of the following?

Adverse Effects

• Which words/phrases describe the primary adverse effects of muscle relaxants that work on both the central nervous system and directly on skeletal muscles? Select all that apply.

Self-Check: Common Muscle Relaxants

Direct-acting Muscle Relaxants

• Which of the following is a direct acting skeletal muscle relaxant?

Reflect: Muscle Relaxants

Muscle Relaxants: Drug Name

• Which of these muscle relaxants in IV form is used to treat skeletal muscle spasms caused by malignant hyperthermia?

Muscle Relaxant Drugs

• Match the drug to the correct category of muscle relaxant:

• Muscle relaxants are indicated for the use of:
• (Select all that apply.)

Muscle Relaxants: Mechanism of Action

• Match the mechanism of action to the correct category of muscle relaxant:

Muscle Relaxants Effects

• For which of these muscle relaxants is marked sedation a common result of use?

Muscle Relaxants

• Which of the following muscle relaxants is used to treat muscle spasms and can be used in an implantable pump device?

Commonly Abused Drug

• Which of these muscle relaxants is commonly abused in combination with an opioid and a benzodiazepine, together referred to as “The Holy Trinity”, producing a heroin-like effect?

Muscle Relaxant Interactions

Nursing Application: Muscle Relaxants

Prepare: Nursing Application: Muscle Relaxants

• Nursing Assessment
• Nursing Implications
• Side Effects

Self-Check: Nursing Assessment

Nursing Assessment

• You are the nurse caring for a patient taking dantrolene for malignant hyperthermia resulting from a recent surgical procedure. Your assessment of this patient will include areas specific to this drug’s mechanism of action and malignant hyperthermia. These areas include

Nursing Assessment

• You are the nurse caring for a patient taking a muscle relaxant. Although you know that muscle relaxants are used for the treatment of muscle spasms and pain, they are still types of CNS depressants. For this reason, you assess for some of the effects of CNS depressants in which of these situations?

Self-Check: Nursing Implementation

Patient Teaching

• As the nurse caring for a patient taking cyclobenzaprine, a centrally acting muscle relaxant, you ensure that you teach the patient which of the following in preparation for discharge?

Nursing Implementation

• You are the nurse caring for a patient taking cyclobenzaprine, a centrally acting skeletal muscle relaxant. He asks you why he must not drink alcohol while taking this medication. Your response is that  

Nursing Implementation

• You are caring for a patient hospitalized for muscle spasms associated with multiple sclerosis. Her health care provider is prescribing baclofen for long term use. Based on your knowledge of this medication, which of the following you would consider? (Select all that apply.)
• begin closely monitoring the patient’s temperature.

Reflect: Nursing Application: Muscle Relaxants

Nursing Assessment

• You are the nurse caring for Tammy, a 35-year-old woman who has just arrived at your unit from post-op. She is exhibiting signs of malignant hyperthermia and her health care provider has ordered a direct acting skeletal muscle relaxant for treatment. Based on your knowledge of this type of medication and its indication for this use, you  ____

Patient Education

• You are the nurse caring for a patient who is taking cyclobenzaprine following an injury. You are completing discharge teaching with your patient which includes information regarding his medication. You explain to him that

Nursing Assessment

• You are the nurse caring for Martha, an 80-year-old patient with arthritis who has started taking cyclobenzaprine. Your nursing assessment pays special attention to (Select all that apply.)

Patient Teaching

• As the nurse caring for Martha the 80-year-old patient with arthritis taking cyclobenzaprine you ensure that you teach her which of the following in preparation for her discharge? (Select all that apply.)............. Continue