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Questions and Answers
Which of the following is NOT a therapeutic use for anxiolytic drugs?
Which of the following is NOT a therapeutic use for anxiolytic drugs?
What is the primary effect of benzodiazepines on the central nervous system?
What is the primary effect of benzodiazepines on the central nervous system?
Which adverse effect is commonly associated with the use of high doses of benzodiazepines?
Which adverse effect is commonly associated with the use of high doses of benzodiazepines?
What characterizes hypnosis in the context of anxiolytics and hypnotics?
What characterizes hypnosis in the context of anxiolytics and hypnotics?
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What mechanism do anxiolytic drugs primarily utilize to alleviate symptoms of anxiety?
What mechanism do anxiolytic drugs primarily utilize to alleviate symptoms of anxiety?
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In which group of patients should benzodiazepines be used with caution?
In which group of patients should benzodiazepines be used with caution?
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Which of the following conditions is treated using lorazepam and diazepam specifically?
Which of the following conditions is treated using lorazepam and diazepam specifically?
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Which neurotransmitter is primarily involved in the anxiety response that anxiolytics target?
Which neurotransmitter is primarily involved in the anxiety response that anxiolytics target?
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Which nursing implementation is recommended for parenteral forms of medication?
Which nursing implementation is recommended for parenteral forms of medication?
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What is a common adverse effect of benzodiazepines?
What is a common adverse effect of benzodiazepines?
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What should be monitored when administering 'Z-drugs' for insomnia in the elderly?
What should be monitored when administering 'Z-drugs' for insomnia in the elderly?
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Which effect is NOT typically associated with the therapeutic use of anxiolytics?
Which effect is NOT typically associated with the therapeutic use of anxiolytics?
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What mechanism primarily distinguishes sedative effects from hypnotic effects?
What mechanism primarily distinguishes sedative effects from hypnotic effects?
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What serious cardiovascular issue can arise with rapid IV administration of a sedative?
What serious cardiovascular issue can arise with rapid IV administration of a sedative?
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What cardiovascular effects may occur with the use of these medications?
What cardiovascular effects may occur with the use of these medications?
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Why should doses be tapered gradually after long-term therapy with anxiolytics?
Why should doses be tapered gradually after long-term therapy with anxiolytics?
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Which statement accurately describes a nursing consideration when administering intravenous benzodiazepines?
Which statement accurately describes a nursing consideration when administering intravenous benzodiazepines?
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What is a primary therapeutic use of diazepam?
What is a primary therapeutic use of diazepam?
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What adverse effect is commonly associated with the administration of intravenous benzodiazepines?
What adverse effect is commonly associated with the administration of intravenous benzodiazepines?
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When differentiating between sedation and hypnosis, what is primarily characterized as sedation?
When differentiating between sedation and hypnosis, what is primarily characterized as sedation?
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Which mechanism describes the action of barbiturates as anxiolytic-hypnotics?
Which mechanism describes the action of barbiturates as anxiolytic-hypnotics?
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In patients receiving benzodiazepines, what adjustment should be considered for narcotic analgesics?
In patients receiving benzodiazepines, what adjustment should be considered for narcotic analgesics?
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What is a potential risk of abruptly withdrawing benzodiazepines in epilepsy patients?
What is a potential risk of abruptly withdrawing benzodiazepines in epilepsy patients?
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Which comfort measure should be prioritized to help patients tolerate the effects of benzodiazepines?
Which comfort measure should be prioritized to help patients tolerate the effects of benzodiazepines?
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Study Notes
Anxiolytic and Hypnotic Drugs
- Anxiety is a feeling of tension, nervousness, apprehension, or fear.
- Sedation is the loss of awareness and reaction to environmental stimuli.
- Hypnosis is extreme sedation, resulting in further CNS depression and sleep.
Benzodiazepines
- Adverse effects include drowsiness, confusion, ataxia, cognitive impairment, and potential for "floppy infant syndrome" if used in the third trimester.
- Use cautiously in patients with liver disease.
- Effects are enhanced by alcohol and CNS depressants.
Therapeutic Uses of Benzodiazepines
- Anxiety disorders: Panic disorder, generalized anxiety disorder (GAD), social anxiety disorder, performance anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, extreme anxiety associated with phobias, and anxiety related to depression and schizophrenia.
- Alcohol withdrawal symptoms: Chlordiazepoxide, chlorazepate, diazepam, and oxazepam.
- Sleep disorders.
- Midazolam: Facilitate amnesia and sedation prior to anesthesia.
- Lorazepam and diazepam: Drugs of choice for terminating status epilepticus.
CNS Effects of Benzodiazepines
- Drowsiness, somnolence, lethargy, ataxia, vertigo, feeling of a "hangover", thinking abnormalities, paradoxical excitement, anxiety, and hallucinations.
GI Effects of Benzodiazepines
- Nausea, vomiting, constipation, diarrhea, and epigastric pain.
Cardiovascular Effects of Benzodiazepines
- Bradycardia, hypotension (especially with IV administration), and syncope.
Nursing Implementation for Benzodiazepines
- Give parenteral forms only when oral forms are not feasible or available, and switch to oral forms as soon as possible.
- Administer IV medications slowly to avoid cardiac complications.
- Provide standby life-support facilities in case of severe respiratory depression.
- Taper dose gradually after long-term therapy, especially in patients with epilepsy, to avoid seizures or withdrawal syndrome.
- Provide comfort measures such as frequent meals, bathroom access, bowel program, and food with medication if GI upset is severe.
Advantages of Benzodiazepines over Barbiturates
- Less potential for addiction.
- Greater safety margin.
- Fewer adverse effects.
"Z-drugs"
- Oral drugs for short-term treatment of insomnia.
- Take before bed and devote 4-8 hours to sleep.
- Use with caution in patients with hepatic or renal impairment.
- Elderly patients are sensitive, so administer lower doses and monitor closely.
Diazepam
- Used to treat muscular disorders or spasticity from degenerative disorders like multiple sclerosis and cerebral palsy.
Nursing Implementation for Benzodiazepines
- Do not mix IV drugs with other solutions to avoid drug interactions.
- Give parenteral forms only when oral forms are not feasible.
- Administer IV drugs slowly to prevent hypotension, bradycardia, and cardiac arrest.
- Reduce the dose of narcotic analgesics in patients receiving benzodiazepines to decrease potentiated effects and sedation.
- Keep patients receiving parenteral benzodiazepines in bed for at least 3 hours.
- Do not allow ambulatory patients to operate motor vehicles after an injection.
- Taper dose gradually after long-term therapy, especially in epileptic patients.
- Provide comfort measures to help patients tolerate drug effects.
Barbiturates
- Barbiturates used as anxiolytic-hypnotics include: amobarbital, butabarbital, mephobarbital, pentobarbital, phenobarbital, and secobarbital.
- They are general CNS depressants inhibiting neuronal impulse conduction in the ascending RAS, depressing the cerebral cortex, altering cerebellar function, and depressing motor output.
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Description
Test your knowledge on anxiolytic and hypnotic drugs, including benzodiazepines and their therapeutic uses. This quiz covers the effects, adverse reactions, and specific applications in conditions like anxiety disorders and alcohol withdrawal. Enhance your understanding of sedation, hypnosis, and the implications of these medications.
