University:
York University
Course:
CHEM 2550 | Pharmacology for Health Sciences
Academic year:

2022
Views:

39

Pages:

3
Author:

Niklas

Heading: Chp 18 CNS depressants p 206 Subheading: Sleep disorders Insomnia: Difficulty with sleep initiation, maintenance Non-pharmacological management Tx of choice: Focus on behavior adjustments/sleep hygiene practices Sleep hygiene practices: Stable bedtime/wake time Limit napping Avoid substances that interfere with sleep Stimulus control: Bed noises, excessive reading, heavy meals, hot fluids Engage in activities that promote relaxation before bedtime Drug therapy: Benzodiazepines, non-benzodiazepines Benzodiazepines: Alprazolam, lorazepam, midazolam MOA: GABA agonist, bind to GABA receptors, having anti-seizure and anti-anxiety effects Uses: Sleep disorders, anxiety disorders, pre-op sedation, muscle spasticity, status epilepticus Administration: Varies depending on drug SE/ADLs: Prominent sedative effects, tolerance, dependence, respiratory depression, hypotension, additive CNS depressive effects with alcohol, teratogenicity, fetal abnormalities, cardiovascular and respiratory depression Other points: Non-benzodiazepines: Zaleplon, eszopiclone Uses: Short-term insomnia Subheading: Benzodiazepines in older adults Elderly have decreased ability to metabolize drugs Risk for falls, dementia, cognitive depression Use sparingly or not at all Interactions: Attempt withdrawal can be fatal; may promote seizures, must be gradually tapered over a period of months Potentially lethal when combined with alcohol Do not take with other sedatives, hypnotics, or analgesics Grapefruit juice will increase alprazolam levels Local anesthetic Lidocaine: Continuous, nonirritant MOA: Inhibits nerve conduction Uses: Infiltration, nerve block, epidural Administration: Infiltration (dermal injection) Spinal + Epidural Anesthesia Spinal (intrathecal): Single dose Short acting, regional anesthesia Drug injected around spinal cord (subarachnoid space) Quick onset, short duration Epidural: Between dura and vertebral wall, takes about 30 minutes to work; longer lasting Uses: Spinal: Total joint replacement, epidural: Childbirth SE/ADR: Postural headache, hypotension, nausea, vomiting, respiratory depression, bradycardia, infection