CNS Drugs

1. Sedatives

   Annotations:

   • Produce a diminished responsiveness to stimuli without producing sleep Reduce anxiety, nervousness, excitability, irritability "anti-anxiety" drugs, or anxiolytics
2. Hypnotics

   Annotations:

   • Produce a more intense depressant effect on CNS and usually produce sleep.

Annotations:

• Very habit forming Teratogenic Potentiates GABA Indications: hypnotics, sedatives, anticonvulsants, anesthesia.

1. phenobarbital

   Annotations:

   • Interactions w/ alcohol, CNS depressants SEs: drowsiness, confusion Assess BP, rr, and pulse before administration Assure pt safety Provide sleep-conducive environment Toxicity: confusion, excitement, deep sleep, coma, pupil constriction, cyanosis, clammy skin, hypotension) Limit caffeine
   1. Enhances GABA
   2. for generalized tonic-clonic
   3. PO/IM: 30-120 mg/day
   4. PO/SubQ/IV/IM: 100-320 mg at bedtime
2. phenobarbital sodium (Nembutal)

   Annotations:

   • IM or IV Adv: drowsiness, syncope, nervousness, agitation, confusion Necrosis if IV is not in vein IM - deep in large muscle mass - gluteal area

1. diazepam (Valium)

   Annotations:

   • Interactions with alcohol, CNS dep. May increase digoxin levels. Assess vitals and paradoxical rxns. Avoid alcohol. Habit forming May produce birth defects.
   1. for anxiety, procedures, convulsions, alcohol withdrawal, muscle relaxant
   2. PO: 2-10 mg, 2-4 times/day.
   3. IV/IM: 2-10 mg, repeated in 3-4 hours
2. midazolam (Versed)

   Annotations:

   • Enhances GABA

1. temazepam (Restoril)

   Annotations:

   • Enhances GABA Used to induce sleep Category X
2. zolpidem (Ambien)

   Annotations:

   • Sleeping agent Does not cause daytime drowsiness Concern of sleepwalking Contraindications w/ sleep apnea
3. eszopiclone (Lunesta)

   Annotations:

   • Longer-acting non-benzodiazipine Used usually as a hypnotic, before bed Unpleasant taste in mouth, headache Must devote at least 8 hours to sleep, take immediately before bed.

Annotations:

• Often contain anti-histamines Depressant effect on CNS Sleep aids, like doxylamine (Unisom) or Diphenhydramine (Sominex) with alcohol may cause respiratory dep, or arrest.

1. Both of these relieve stress, anxiety, and enhances sleep.
   1. Kava

      Annotations:

      • For stress, anxiety, restlessness, sleep enhancement. Negative interactions with alcohol, barbiturates, and psychoactive drugs. Cont: Parkinson's, liver disease, alcoholism, pregnancy, lactation
   2. Valerian root

      Annotations:

      • For anxiety, restlessness, and sleep issues.

1. baclofen (Lioresal)
2. cyclobenzaprine (Flexeril)
3. dantrolene (Dantrium)

1. amphetamine
2. cocaine

1. sumatriptan (Imitrex)
2. rizatriptan (Maxalt)

1. Ergotamine tartrate (Ergomar)

1. phenobarbital (Luminal)

1. phenytoin (Dilantin)
2. fosphenytoin (Cerebyx)

1. carbamazepine (Tegretol)

1. gabapentin (Neurontin)
2. valproates (Depakote)

1. Levodopa & carbidopa (Sinemet)

1. pramipexole (Mirapex)

1. Amatadine (Symmetrel)
2. Catechol-O-methyltransferase inhibitors
   1. Entacopone (Comtan)

1. benzotropine mesylate (Cogentin)

1. alprazolam (Xanax)
2. diazepam (Valium)
3. lorazepam (Ativan)

1. buspirone (BuSpar)