Some drugs are used to treat anxiety or to produce hypnosis that do not fall into either the benzodiazepine or the barbiturate group. Such medications include the following:
有些药物用于治疗焦虑或催眠，这些药物既不属于苯二氮卓类，也不属于巴比妥酸盐类。这些药物包括：
• Antihistamines (promethazine [Phenergan], diphenhydramine [Benadryl]) can be very sedating in some people. They are used as preoperative medications and postoperatively to decrease the need for narcotics.
抗组胺药（异丙嗪[非那根], 苯海拉明[苯那君]）对某些患者来说非常具有镇静性。他们作用术前、术后用药，以减少麻醉药品需要。
• Buspirone (BuSpar), a newer antianxiety agent, has no sedative, anticonvulsant, or muscle relaxant properties, and its mechanism of action is unknown. However, it reduces the signs and symptoms of anxiety without many of the CNS effects and severe adverse effects associated with other anxiolytic drugs. It is rapidly absorbed from the GI tract, metabolized in the liver, and excreted in urine.
• Chloral hydrate (Aquachloral) is frequently used to produce nocturnal sedation or preoperative sedation. Its mechanism of action is unknown. It is rapidly absorbed from the GI tract and metabolized in the liver and kidney for excretion in the bile and urine.
• Dexmedetomidine (Precedex) is given intravenously at a starting dose of 1 mcg/kg over 10 minutes and then a controlled infusion for up to 24 hours. It is used for the sedation of newly intubated and mechanically ventilated patients in an intensive care unit.
• Eszopiclone (Lunesta) is a new agent used to treat insomnia. It is thought to react with GABA sites near benzodiazepine receptors. It is rapidly absorbed, metabolized in the liver, and excreted in the urine.
• Meprobamate (Miltown) is an older drug that is used to manage acute anxiety for up to 4 months. It works in the limbic system and thalamus and has some anticonvulsant properties and central nervous system muscle-relaxing effects. It is rapidly absorbed and is metabolized in the liver and excreted in urine.
• Ramelteon (Rozerem), introduced in 2005, is the first of a new class of sedatives/hypnotics, the melatonin-receptor agonists. This drug stimulates melatonin receptors, which are thought to be involved in the maintenance of circadian rhythm and the sleep-wake cycle. Ramelteon is used for the treatment of insomnia characterized by difficulty with sleep onset. It is rapidly absorbed, with peak levels in 30 to 90 minutes. It is metabolized in the liver and excreted in the feces and urine.
• Zaleplon (Sonata) and zolpidem (Ambien), both of which cause sedation, are used for the short-term treatment of insomnia. They are thought to work by affecting serotonin levels in the sleep center near the RAS. These drugs are metabolized in the liver and excreted in the urine.
promethazine – n. 异丙嗪
Phenergan – n. 非那根
diphenhydramine – n. 苯海拉明
Benadry – n. 苯那君
buspirone – n. 丁螺环酮
BuSpar – n. 布斯帕
chloral hydrate – n. 水合氯醛
Aquachloral – n. 水合氯醛商品名
dexmedetomidine – n. 右美托咪啶
Precedex – n. 普利斯德
eszopiclone – n. 艾司佐匹克隆
Lunesta – n. 鲁尼斯塔
meprobamate – n. 甲丙氨酯
Miltown – n. 眠尔通
ramelteon – n. 雷美替胺
Rozerem – n. 柔速瑞
circadian – a. 昼夜节律的，生理节奏的
circadian rhythm – 昼夜节律
sleep-wake cycle – 睡醒周期
zaleplon – n. 扎来普隆
Sonata – n. 思威坦
zolpidem – n. 唑吡坦
Ambien – n. 安必恩
serotonin – n. 血清素，5-羟色胺
1. Nurse Rita is giving instructions to her client who is taking antihistamine. Which of the following nurse teachings is appropriate for the client?
A. Avoid ingesting alcohol.
B. Be aware that you may need to take a decongestant.
C. Be aware that you may have increased saliva.
D. Expect a relief in 24 hours. 2. Daniel has vertigo, which antihistamine is best for his condition?
A. Terfenadine
B. Meclizine
C. Hydrocodone
D. Guaifenesin
奥医教育ISPN / NCLEX-RN “在线自测”题库，复习练习效果检验一站完成
答案 Key to Questions
1. A. Avoid ingesting alcohol.
Because alcohol and antihistamines have sedating properties, concurrent administration of these drugs should be avoided. Antihistamines and decongestants are often given together. Dry mouth is a common side effect, not increased salivation. Not all antihistamines last 24 hours. 2. B. Meclizine.
Meclizine (Antivert) is given for vertigo and motion sickness. Choices C and D are not antihistamines. Choice A is an antihistamine, but meclizine is the standard drug in the treatment of vertigo.
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