CNS depressants and stimulants

Benzo

moa: decrease CNS activity by enhancing GABA receptors in the hypothalamic, thalamic, and limbic systems.

Drugs: pam or am

indications: anxiety, seizures, insomnia, muscle spasms, procedural sedation

AE: drowsiness, dizziness, paradoxical excitement, lethargy, cognitive impairment, fall risk in elderly

Nursing: monitor RR and HR, dont give with opioids, alcohol, and other sedatives. can be deadly with other depressants

monitor airway, alertness, and reflexes

benzo toxicity and antidote

SX: respiratory depression, coma, hypotension, seizures, slurred speech, ataxia, altered mental status. 

Antidote: Flumazenil

Barbs

indicated: seizures, insomnia, anesthesia induction

Safety concerns: enzyme inducers, reducing other drugs effects, narrow therapeutic index high risk for overdose, check for polypharmacy, dont give with alcohol.

Barbs

ultrashort acting: Thiopental

short acting: pentobarbital

long acting: phenobarbital

amphetamine and methylphenidate

moa: stimulates the release of norepinephrine and dopamine in the CNS- increased alertness, focus, mood, and decreased fatigue and appetitie

indications: ADHD, narcolepsy, short term obesity tx

AE: insomnia, tachycardia, htn, anorexia, weight loss, restlessness, growth suppression

Teaching: give before breakfast and lunch, not after 4-6 pm, avoid caffeine, evaluate abuse potential. consider drug holidays

monitor: BP, weight, hr, height

stimulant vs non stimulant adhd

stimulant works faster but with more side effects

non-stimulant works slower and lower abuse potential