Sleep Cycle in Children and Older Adults

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Questions and Answers

What is the main reason short-acting hypnotics are useful for achieving sleep?

They allow patients to awaken early in the morning without lingering side effects (correct)

They increase the duration of sleep cycles

They can be used as anxiolytics

They induce REM sleep within minutes

What is the classification of barbiturates under the Controlled Substances Act?

Schedule II for short-acting, Schedule III for intermediate-acting, and Schedule IV for long-acting (correct)

Schedule IV for short-acting and Schedule III for long-acting

Schedule I for short-acting and Schedule IV for long-acting

Schedule III for short-acting and Schedule II for long-acting

What is the term for residual drowsiness experienced after taking a hypnotic?

Dependence

Hangover (correct)

Rebound

Sedation

What is the purpose of monitoring vital signs in patients taking short-acting barbiturates?

To monitor for respiratory depression Signup and view all the answers

What is the term for vivid dreams and nightmares that occur after taking a hypnotic?

REM rebound Signup and view all the answers

What is the primary use of secobarbital?

Procedure sedation Signup and view all the answers

How do the liver and body handle barbiturates?

The liver bio-transforms them into active metabolites Signup and view all the answers

What is the intermediate-acting barbiturate used for sustaining long periods of sleep?

Butabarbital Signup and view all the answers

What is the primary mechanism of action of melatonin agonists?

Selective targeting of melatonin receptors Signup and view all the answers

What is a potential risk associated with taking CNS depressants with nonbenzodiazepine hypnotics?

Respiratory depression Signup and view all the answers

What is the primary purpose of assessing baseline vital signs and laboratory tests in patients taking sedative-hypnotics?

To establish a baseline for future comparisons Signup and view all the answers

What is a common adverse effect of ramelteon?

Drowsiness Signup and view all the answers

What is the primary purpose of anesthetics?

To alleviate pain and cause a loss of consciousness Signup and view all the answers

What is a potential risk associated with taking sedative-hypnotics for several days?

Hangover side effects Signup and view all the answers

What is the half-life of ramelteon?

1-2.6 hours Signup and view all the answers

What is the primary purpose of assessing a patient's sleep disturbance?

To identify the underlying cause of insomnia Signup and view all the answers

Which stage of sleep do children experience the least?

REM Signup and view all the answers

What is the mildest form of CNS depression?

Sedation Signup and view all the answers

High doses of sedative-hypnotics can suppress which part of the brain leading to respiratory depression?

Medulla Signup and view all the answers

Which of these drugs is categorized under anorexiants?

Phendimetrazine Signup and view all the answers

What common side effect can result from taking barbiturates, although it is rare?

Skin rashes Signup and view all the answers

Why are barbiturates less frequently prescribed now?

They have many side effects and a high potential for dependency Signup and view all the answers

Study Notes

Barbiturates

Classified under the Controlled Substances Act: Schedule II for short-acting, Schedule III for intermediate-acting, and Schedule IV for long-acting hypnotics
Long-acting group includes Phenobarbital and Mephobarbital, used to control seizures in epilepsy
Intermediate-acting barbiturates, such as Butabarbital, are useful as sleep sustainers for maintaining long periods of sleep

Side Effects and Adverse Reactions

Hangover: residual drowsiness, impaired reaction time due to lingering active metabolites in the body
REM Rebound: vivid dreams and nightmares, occurs after taking a hypnotic, especially after prolonged use and abrupt stopping

Pharmacokinetics

Liver bio transforms hypnotics into active metabolites that persist in the body, causing drowsiness

Nursing Process: Patient-Centered Care

Assess baseline vital signs and laboratory tests for future comparisons
Obtain a drug history, especially CNS depressants with nonbenzodiazepine hypnotics that can depress respirations
Ascertain the patient’s problem with sleep disturbance

Melatonin Agonists

Act by selectively targeting melatonin receptors to regulate circadian rhythms in the treatment of insomnia
Ramelteon: has a half-life of 1 to 2.6 hours, with adverse effects including drowsiness, dizziness, fatigue, headache, nausea, and suicidal ideation

Anesthetics

Classified as general and local, depress the CNS, alleviate pain, and cause a loss of consciousness
First anesthetic, nitrous oxide (“laughing gas”), was used for surgery in the early 1800s

Children and Older Adults Sleep Cycle

Children: few REM sleep periods, longer periods of stage 3 and 4 NREM sleep
Older adults: decrease in stage 3 and 4 NREM sleep, frequent waking periods

Sedative-Hypnotics

Treatment of sleep disorders
High doses can suppress the respiratory center in the medulla, causing respiratory depression
Hypersensitivity: skin rashes and urticaria can result from taking barbiturates

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Description

This quiz covers the differences in sleep cycles between children and older adults, including the stages of NREM sleep and the effects of sleep disorders.