CNS Stimulants + Depressants Exam 2

Nonpharmacologic methods to induce sleep

Techniques such as avoiding caffeine and alcohol 6 hours before bedtime, regular wake-up times, and taking warm baths that promote sleep without medication.

Actions of benzodiazepines as a hypnotic

Interacts with GABA neurotransmitter to reduce neuron excitability, lower doses assist with anxiety, higher doses induce sedation and hypnosis.

Indications for benzodiazepines

Anxiety disorders, alcohol withdrawal, hyperexcitability, agitation, and as sedative hypnotics for inducing sleep.

Patient education for benzodiazepines

Advise gradual withdrawal, avoid alcohol and CNS depressants, and refrain from driving or operating machinery.

Barbiturates

CNS depressants ending in -am that bind to barbiturate sites at GABA-receptor complex enhancing GABA activity.

Mode of action of nonbenzodiazepines (zolpidem, Ambien)

Acts at GABA receptors to influence inhibitory neurotransmission throughout the CNS, with a duration of action of 6-8 hours.

Patient teaching for nonbenzodiazepines

Monitor for side effects like hangover and dizziness, avoid alcohol and other CNS depressants, and urinate before taking.

Melatonin agonists (ramelteon)

Medications that selectively target melatonin receptors to regulate circadian rhythms for treating insomnia.

Patient education for older adults using sedative hypnotics

Use nonpharmacologic methods first; prefer short to intermediate acting benzodiazepines.

ADHD treatment medications

Includes amphetamines like methylphenidate (Ritalin, Concerta) and dexmethylphenidate; require careful nursing interventions.

Nursing interventions for ADHD

Encourage sugarless gum for dry mouth, monitor weight, advise drug tapering, and emphasize counseling for affected children.

Common side effects of amphetamines

CV: Tachycardia, hypertension; CNS: Restlessness, insomnia; GI: Anorexia, weight loss.

Common side effects of analeptics

CV: Tachycardia; CNS: Insomnia, seizures; Respiratory: Cough, dyspnea.

Common side effects of caffeine

CV: Palpitations; CNS: Headache, insomnia; GI: Nausea; Renal: Urinary frequency.

Patient education for narcolepsy treatment

Monitor for side effects like headache and insomnia; caution on driving.

Differences between ADHD and narcolepsy

ADHD involves attention deficits with stimulants for treatment, while narcolepsy includes excessive daytime sleepiness managed with wakefulness-promoting agents.

Avoidances for benzodiazepines usage

Avoid alcohol, other CNS depressants, and driving or operating heavy machinery.

Long term use of ADHD medications

May lead to drug abuse and requires regular monitoring, including blood draws.

Warm milk before bedtime

A traditional nonpharmacologic method that may promote sleep through its calming effects.

ADHD amphetamine drugs

methylphenidate

• ritalin (short acting)

• concerta (long acting)

narcolepsy amphetamine drugs

• modafinil (provigil)

  • armodafinil (nuvigil); updated version of provigil