Pharmacology: Sedation and Sleep Drugs

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Questions and Answers

Which of the following is NOT typically considered a cause of insomnia?

Consuming large meals before bedtime

Changes in lifestyle or environment

Daily exercise and physical activity (correct)

Experiencing pain or illness

A medication that causes relaxation without necessarily leading to sleep is known as a:

Stimulant

Sedative (correct)

Analgesic

Hypnotic

Which effect is LEAST associated with sedative-hypnotic therapy?

Increase in time spent in stage 2 sleep

Decrease in overall time spent sleeping (correct)

Reduction in the number of REM cycles

Potential for REM rebound upon ceasing the medication

Which of the following is NOT explicitly listed as a nursing implication for sedative-hypnotic therapy?

Renal function Signup and view all the answers

Which type of insomnia is characterized by waking up and being unable to fall back asleep?

Terminal insomnia Signup and view all the answers

Besides treating insomnia, sedative-hypnotics might also be used for what?

As anticonvulsive agents Signup and view all the answers

According to the provided information, what should be monitored when implementing sedative-hypnotic therapy?

Effectiveness of medication Signup and view all the answers

When educating a patient about sedative-hypnotic therapy, which topic is most emphasized for improving sleep?

Bedtime routine and environmental control Signup and view all the answers

A patient experiencing insomnia related to anxiety about a procedure could be best treated with which medication?

Hypnotic Signup and view all the answers

Which of the following is NOT specifically mentioned as a topic in patient education for sedative-hypnotic therapy?

Financial planning Signup and view all the answers

Which of these is NOT a typical effect of benzodiazepines?

Combative behavior Signup and view all the answers

What is the primary action of benzodiazepines concerning GABA receptors?

Stimulating the release of GABA Signup and view all the answers

Which of the following is NOT a common adverse effect of benzodiazepines?

Hallucinations Signup and view all the answers

Flumazenil is used in the management of what condition related to benzodiazepines?

Overdose Signup and view all the answers

What is a potential cardiovascular side effect associated with both benzodiazepines and nonbenzodiazepine sedative-hypnotics?

Transient hypotension when arising Signup and view all the answers

Which of these psychological effects is more associated with nonbenzodiazepine sedative-hypnotics than with benzodiazepines?

Restlessness Signup and view all the answers

Which of the following drug classes impacts both type 1 and type 2 GABA receptors?

Benzodiazepines Signup and view all the answers

Which term describes a drug that induces a state of unconsciousness from which a person can be aroused by an appropriate stimulus?

Hypnotic Signup and view all the answers

What assessment is essential before administering both benzodiazepines and nonbenzodiazepine sedative-hypnotics?

Premedication assessment Signup and view all the answers

A patient reports difficulty falling asleep at the beginning of the night. Which type of insomnia is this most indicative of?

Initial insomnia Signup and view all the answers

During which stage of NREM sleep would a healthy young adult typically spend the largest portion of their sleep time?

Stage 2 Signup and view all the answers

Following a normal sleep cycle, after Stage 4 of NREM sleep, what is the next stage the individual will transition to?

Stage 3 Signup and view all the answers

What is the primary purpose of sleep in maintaining overall health?

Maintain psychiatric equilibrium and strengthen the immune system Signup and view all the answers

A patient is prescribed a benzodiazepine for long-term management of a sleep disorder. Which of the following lab tests should be monitored regularly?

Liver function tests Signup and view all the answers

Which of the following is the primary difference when comparing the effects of benzodiazepines to nonbenzodiazepines on the central nervous system?

Benzodiazepines have a greater potential for abuse and dependence than nonbenzodiazepines. Signup and view all the answers

A patient is experiencing symptoms of a benzodiazepine overdose. Which medication is indicated to counteract the effects of this overdose?

Flumazenil Signup and view all the answers

Study Notes

Drugs Used for Sedation and Sleep

The chapter covers drugs used for sedation and sleep.
The text differentiates between sedatives and hypnotics.
Sedatives relax, while hypnotics induce sleep.
Insomnia is categorized as initial, intermittent, terminal, transient, short-term, and chronic.
Rebound sleep is also discussed.
Nursing interventions as alternatives to medication are also addressed.
The chapter analyzes benzodiazepines and nonbenzodiazepines' effects on the central nervous system.
Flumazenil is identified as the antidote for benzodiazepine overdose.
Laboratory tests to monitor during extended benzodiazepine use are outlined.
Sleep is described as a state of unconsciousness.
Sleep is necessary for maintaining psychiatric equilibrium and strengthening the immune system.
REM sleep is associated with dreaming.
NREM sleep is divided into four stages.
A healthy young adult sleep cycle typically runs through NREM and REM phases in a 90-minute period. The stages progression follows Stage 1, then 2, 3, and 4 then back to 3, 2 and lastly REM.
Stage 2 accounts for the largest proportion of sleep time in adults.
Insomnia is the most frequent sleep disorder, usually mild and short-lived.
Common causes of Insomnia include lifestyle changes, pain, illness, anxiety, high caffeine intake, and large meals before bedtime.
Insomnia is categorized into initial, intermittent, and terminal.
Initial insomnia is characterized by difficulty falling asleep, while intermittent insomnia involves difficulty maintaining sleep.
Terminal insomnia is defined by waking up and struggling to return to sleep.
Sedative-hypnotic therapy is used for temporary insomnia treatment, alleviating anxiety, and/or inducing sleep before procedures.
7 to 8 hours of sleep is considered optimal for good health.
Nursing implications for sedative-hypnotic therapy include monitoring central nervous system function, vital signs, sleep patterns, anxiety levels, environmental factors, nutritional needs, alcohol intake, exercise and respiratory status.
The nurse should obtain vital signs periodically, and administer preoperative medications at the correctly scheduled time.
As-needed medications should be reviewed with the patient to gauge effectiveness of the therapy. A repeat dose may be necessary if the attending medical professional prescribes it.
Patient education should include information about bedtime routines, avoiding heavy meals before sleep, promoting personal comfort, encouraging environmental control, recommending activity and exercise, teaching stress management techniques, fostering health maintenance, and patient self-assessment.
Anxiety about an upcoming procedure is often associated with insomnia; in this case, a hypnotic medication is the most recommended therapy.
A low-dose sedative-hypnotic can be prescribed for insomnia, dizziness, combative behavior, or hallucinations.
Benzodiazepines are widely used sedative-hypnotic agents.
Benzodiazepines are known for having a wide safety margin and over 2000 derivatives; however, it is difficult to classify as a class. Antianxiety agents, Anticonvulsants, and Sedative-hypnotic agents are derivatives in this class.
Benzodiazepines act by affecting type 1 and type 2 GABA receptors. This leads to stimulating the release of GABA which has sedative and conscious sedation effects.
Common adverse effects include drowsiness, hangover, sedation, lethargy, and a reduced level of alertness.
Serious adverse effects include confusion, agitation, amnesia, and hepatotoxicity and Flumazenil manages intentional or accidental overdose.
Common adverse effects during benzodiazepine use include neurologic symptoms (drowsiness etc.), cardiovascular symptoms (transient hypotension), psychological symptoms (confusion etc).
Excessive use or abuse of benzodiazepines may lead to blood dyscrasias or hepatotoxicity.
Non-benzodiazepine sedative-hypnotic medications act by variable effects on REM sleep, for use in sedatives and hypnotics.
Common adverse effects include hangover, sedation, lethargy, decreased alertness, transient hypotension upon arising, restlessness, and anxiety.
Concerning non-benzodiazepine sedative-hypnotic agents, nursing implications involve premedication assessments, reviewing availability, dosage, and administration, knowledge of common adverse effects (neurological, cardiovascular, and psychological), and being aware of potential drug interactions especially with fluvoxamine, rifampin, and food.
Newer non-benzodiazepine medications for insomnia are preferred due to less interference with natural sleep cycles and safer for long-term use.

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Description

This quiz explores the pharmacology of drugs used for sedation and sleep. It highlights the differences between sedatives and hypnotics, and discusses insomnia types and nursing interventions. Additionally, it covers benzodiazepines, nonbenzodiazepines, sleep stages, and the significance of sleep for health.