PHARMACOLOGY- 3/15/16

CNS
*CNS DEPRESSANT
Nervous system
-Control human body functions
-Analyze incoming stimuli
-Integrate internal,centra responses
Brain and spinal cord
Neurons
Action potential
-messages sent by nerves
Depolarization-stimulation of neurons, positively charged
Rrpolarization- cell return to resting state, negatively charged
-electrical impulse conduction bet nerves to communicate w/ each other
NEUROTRANSMITTERS
Acetylcholine-communicate bet nerves and muscle
Norepinephrine and Epinephrine- catecholamines, released nerves of the
sympathetic branch of the ANS
Dopamine- high concentration in certain areas of the brain for the
coordination of impulses both motor and intellectual
Gamma-aminobutryic- acid (GABA)- inhibit nerve activity; prevent over
excitability of brain
Serotonin- prevents depression and promotes motivation; for arousal and
sleep
ANXIOLYTICS AND HYPNOTIC AGENTS
Anxiolytics- prevents feelings of tension or fear (can have sleep and rest,
relax)
Sedatives- calms the patient and makes them unaware of the environment
Hypnotics- can cause sleep
Minor Tranquilizer- can produce a state of tranquility in an anxious client
ANXIETY
- unpleasant feeling of tension, fear, or nervousness in response to an
environmental stimulus
-Accompanied by s/ax of sympathetic stress reactions
-Can become overwhelming and interfere w/ ADLs and chronic stimulation of
the SNS
Sedation- loss of awareness and reaction to environmental stimuli

Hypnosis- extreme sedation resulting to CNS depression and sleep

Benzodiazepines- act as limbic system and the RAS to make gamma-amino
butryic acid more effective causing interference w/ neuron firing
-These makes gamma more effective
Indicated: for anxiety disorders, alcohol withdrawal, hyper excitability and
agitation and preoperative relief of anxiety and tension to aid in balanced
anesthesia
BENZODIAZEPINE:
Alprazolam (Xanax)
Chloridiazepoxide- withdrawal
Clonazepam- seizures,neuralgia so, manic episodes
Cautions use:
Pyschosis
Acute alcohol intoxication
Pregnancy-cleft lip
Theophylline and ranitidine
ADVERSE EFFECTS:
CNS- drowsiness, lethargy, blurred vision,mild paradoxical excitatory reaction
GI- dry mouth, constipation N/V, high liver enzymes
CV- hypo/hypertension arrythmiaspalpitations and respiratory difficulties
GU- hesitancy or retention, low libido
Hematologist-blood days radial and anemia so
Local injection site- phlebitis, thrombosis, irritations
Abrupt cessation
BARBITURATES
-gen CNS depressant, inhibit neuronal impulse conduction in ascending RAS
-depress cerebral cortex
-indicated relief of s/sx of anxiety, sedation, insomnia, pre anesthesia and
seizures
-absorbed well reaching peak levels I 20-60 mins
Known to induce liver enzymes system
Armobarbital
Ending in *bital
Long acting- phenobarbital
Ultrashort acting- 10 mins
Short/
Caution Use:
His of addiction
Hepatic and renal impairment
Respi distress and dysfunction
Pregnancy
Pain- acute or Chronic
Seizure disorders

Drug interactions
Alcohol, CNS depressant antihistamines
Phenytoin- altered response
MAOI- inc serum levels
Dec effectsADVERSE EFFECTS
-dev of physical tolerance and psychological dependence
-CNS Depression: drowsiness, somnolence, lethargy, ataxia, feeling of
hangover, thinking abnormalities, paradoxical
GI:n/v, constipation, diarrhea, and epigrams trick pain
CD: bradycardia, hypotension and syncope
RESPI: serious hypoven- NI: watch for RR, RESPI depression and
laryngospasm
Hypersensitivity Rx: rash, steven-Johnson
NURSING CARE:
Do not mix w/ other solutions
Give IV Drugs- don't administer arterially
Provisions for safety
Standby life support facilities
Void before admin and institute bowel program
Taper the dosage gradually after long term therapy
Monitor CBC, renal and hepatic function
Antidote for benzodiazepines: flumanezil(anexate)
Other Anxiolytics/Hypnotic Drugs
Par aldehyde- delirium tremens and extreme excitement, do not admin or
dispense in plastic container
Choral hydrate- Nocturnal sedation or pre-op sedation
Zalepon(Sonata) and Zolpidem(Ambien)- short treatment for insomnia
Antihistamines pre-op and post-op medication
Monitor for thickened respiratory secretions
Bus pirogue- (BuSpar)- No sedative, anticonvulsant or muscle relaxant
property