Kaye Andrea D.

Rico Contraindications

Adrenergic Blocking Drugs, Contraindicated in hypersensitivity to the

Cholinergic Drugs, active substance or other types of
quinazolines, patients with a history of
Sedatives and Hypnotics
orthostatic hypotension, during lactation (for
Adrenergic Blocking Drugs the hypertension indication only).

- Bind to adrenergic receptors, but inhibit or

block stimulation of the sympathetic nervous Side effects
system (SNS). Have the opposite effect of
adrenergic drugs, they are also known as: Low blood pressure, dizziness, shortness of
Adrenergic antagonists, Sympatholytics breath, tiredness, abdominal pain, diarrhea,
blockers, α (alpha)-blockers and β (beta)- headache and swelling of your feet, hands,
blockers. arms, and legs
 DOXAZOSIN Adverse effects
Dizziness, headache, vertigo, hypotension,
abdominal pain, nausea, vomiting and
dyspnea
Drug to drug interactions
Antihypertensives, diuretics- May increase
hypotensive effects. Adjust dosage as
necessary
Brand Name: Cardura Nursing Responsibilities
Dosage
■ Instruct patient to take drug exactly
Adults: 1 mg immediate release tablet P.O. as prescribed
daily. May increase to 2 mg and thereafter 4
mg and 8 mg once daily, if needed. ■ Monitor BP closely

Route and Form: ■ Advise patient to consult prescriber if

dizziness or palpitations are
Oral/ Tablet bothersome.
Mechanism of Action ■ Advise patient to rise slowly from
Doxazosin selectively inhibits the sitting or lying position
postsynaptic alpha-1 receptors on vascular
smooth muscle by nonselectively blocking
the alpha-1a, alpha-1b, and alpha-1d
subtypes
Indication
Doxazosin is used alone or with other drugs
to treat high blood pressure (hypertension).
Lowering high blood pressure helps prevent
strokes, heart attacks, and kidney problems.
 Indication:

Cholinergic drug  Used to increase smooth muscle tone, as in

the GI tract following abdominal surgery or in
Cholinergic drug, any of various drugs urinary retention in the absence of
that inhibit, enhance, or mimic the action obstruction. It may cause hypotension,
of the neurotransmitter acetylcholine, cardiac rate changes, and bronchial spasms.
the primary transmitter of nerve impulses
within the parasympathetic nervous Contraindications:
system—i.e., that part of the autonomic Contraindicated in patients with asthma,
nervous system that contracts smooth coronary insufficiency, peptic ulcers,
muscles, dilates blood vessels, increases intestinal obstruction and hyperthyroidism.
bodily secretions, and slows the heart
rate. Side effects

 BETHANECOL Dizziness, drowsiness, lightheadedness,

headache, nausea, vomiting, abdominal
cramps/pain and diarrhea
Adverse effects
Headache, seizures, bradycardia, lacrimation,
urinary urgency
Drug to drug Interactions
Anticholinergics, atropine, procainamide:
May reverse cholinergic effects. Observe
patient for lack of drug effect
Nursing Responsibilities
Brand Name: Duvoid  Monitor vital signs frequently,
Dosage especially respirations

Urinary Retention  Watch closely for adverse reactions

that may indicate drug toxicity
Adult: 10-50 mg orally three/four times daily
 Tell patient to take drug on an empty
Some patients may require doses of 50-100 stomach and at regular intervals
mg orally twice daily
Take 1 hour before meals or 2 hours after
meals
Route and Form:
Oral/Tablet
Mechanism of Action:
Bethanechol directly stimulates cholinergic
receptors in the parasympathetic nervous
system while stimulating the ganglia to a
lesser extent. Its effects are predominantly
muscarinic, inducing little effect on nicotinic
receptors and negligible effects on the
cardiovascular system.
 Sedatives and Hypnotics Mechanism of Action

Sedatives are drugs that decrease activity Bind to receptors in various regions of the
and have a calming, relaxing effect. People brain and spinal cord. This binding increases
use these drugs mainly to reduce anxiety. At the inhibitory effects of gamma-aminobutyric
higher doses, sedatives usually cause sleep. acid (GABA). GABAs functions include CNS
Drugs used mainly to cause sleep are called involvement in sleep induction. Also involved
hypnotics. The difference between sedatives in the control of hypnosis, memory, anxiety,
and hypnotics, then, is usually the amount of epilepsy and neuronal excitability 
the dose—lower doses have a calming. Indication
Barbiturates and benzodiazepines are the
two major categories of sedative-hypnotic. Indicated for the management of anxiety
disorders or for the shortterm relief of the
Benzodiazepines -used to treat anxiety symptoms of anxiety.
disorders, nervousness, panic disorders,
muscle spasms, alcohol withdrawal, status Contraindications
epilepticus, premenstrual syndrome, and as Contraindicated in patients with a known
sedation during surgery. Common hypersensitivity to diazepam and in patients
benzodiazepines include diazepam (Valium), with myasthemia gravis, severe respiratory
alprazolam (Xanax), lorazepam (Ativan), insufficiency, sleep apnea syndrome.
temazepam (Restoril), and clonazepam
(Klonopin). Side effects
Drowsiness, tiredness or fatigue, muscle
weakness, inability to control muscle
 Diazepam movements (ataxia), headache, tremor,
dizziness, dry mouth or excessive saliva
Adverse effects
Drowsiness, slurred speech, tremor, fatigue,
ataxia, headache, CV collapse, bradycardia,
respiratory depression
Drug to drug interaction
Taking certain drugs that treat allergies or
Brand Name: Valium colds along with diazepam can increase your
risk of drowsiness or sleepiness. Taking
Dosage certain antidepressants with diazepam can
Anxiety and Seizure increase your risk of drowsiness or
sleepiness. It can also cause your breathing
Adults: depending on severity, 2 to 10 mg to slow down or stop.
P.O, daily or b.i.d.
Nursing Responsibilities
Children age 6 months and older: 1 to 2.5 mg
P.O. t.i.d or q.i.d , increased gradually as ■ Monitor HR, BP, and mental status
needed. changes. Patients are at an increased
risk for falls
Route and Form
■ Warn patient to report all adverse
Oral/ Tablet reactions and to avoid activities that
require alertness and good
coordination
 ■ Warn patient not to abruptly stop transmembrane chloride channels leading to
drug because withdrawal symptoms cellular hyperpolarization within the central
may occur nervous system.
■ Advise female patient to avoid use Indications
during pregnancy; inform her of the
Indications include short-term sedative for
potential hazard to the fetus
the treatment of insomnia, and as a pre-
anesthetic for surgery
Contraindication

Barbiturate- A barbiturate is a drug Contraindicated in patients with a history of

that acts as a central nervous system barbiturate hypersensitivity.
depressant, and can therefore produce a Side Effects
wide range of effects, from mild sedation
to death. Common barbiturates include Drowsiness, dizziness; loss of balance or
secobarbital (Seconal); butalbital, aspirin, coordination; nausea, vomiting, constipation;
and caffeine (Fiorinal); thiopental overactive reflexes; sleep problems
(Pentothal); and pentobarbital (insomnia), nightmares; or feeling restless or
(Nembutal). excited (especially in children or older adults)

 PENTOBARBITAL Adverse Effects

Drowsiness, slurred speech, tremor, fatigue,
ataxia, headache, CV collapse, bradycardia,
respiratory depression
Drug to drug interactions
Pregnancy (category D) or lactation. History
of sensitivity to barbiturates; parturition,
fetal immaturity, uncontrolled pain.
Nursing Responsibilities
■ Monitor BP, pulse, and respiration
q3–5min during IV administration.
Brand name: Nembutal Observe patient closely; maintain
Dosage airway. Have equipment for artificial
respiration immediately available.
Hypnotic
■ Observe patient closely for adverse
Initial: 100 mg IV OR 150-200 mg IM effects for at least 30 min after IM
May give small increments of drug after at administration of hypnotic dose.
least 1 minute to reach full effect ■ Avoid alcohol and other CNS
Not to exceed 500 mg depressants for 24 h after receiving
this drug
Route and Form
Parenteral/ Injection
Mechanism of action
GABA receptors are activated resulting in
enhanced GABA binding and opening of
References:
https://nurseslabs.com/adrenergic-
antagonists-sympatholytics/
https://medlineplus.gov/druginfo/meds/a68
2245.html
https://www.drugbank.ca/drugs/DB00590
http://www.addictionrecov.org/Addictions/?
AID=38
https://www.rxlist.com/tranxene-
drug.htm#warnings
https://www.mayoclinic.org/drugs-
supplements/clorazepate-oral-
route/description/drg-20072306
https://www.encyclopedia.com/education/a
pplied-and-social-sciences-
magazines/sedative-and-sedativ
https://www.medicinenet.com/benzodiazepi
nes_vs_barbiturates/article.htme-hypnotic-
drugs