2.4 Sedatives - Hypnotics (Barbiturates and Benzodiazepines) Flashcards
What is the purpose of sedatives?
Reduce nervousness, excitability, and irritability without causing sleep, but can be hypnotic if given in a large enough dose
What is the purpose of hypnotics?
Cause sleep and have a much more potent effect on the CNS than sedatives.
Many drugs act as either a sedative or a hypnotic, and so they are called what? What are the 3 classes?
Sedative-hypnotics
Barbiturates
Benzodiazepines
Miscellaneous agents
Barbiturates are…
A class of drugs that are chemical derivatives of barbituric acid. They are used to induce sedation
Habit forming
Have a narrow therapeutic window
Barbiturates were first introduced into clinical use in…
- They were used as the standard drug for treating insomnia and producing sedation
Only few in use today ie: phenobarbitAL or PentothAL
What are the indications for Barbiturates?
Hypnotic
Sedative
Anticonvulsant - for seizures
Anesthetic for surgical procedures
What 4 effects do Barbiturates have on the CNS?
Drowsiness, lethargy, vertigo, mental coma
What 4 effects do Barbiturates have on the respiratory system?
Depression, apnea, bronchospasm, cough
Signs of Barbiturate overdose include…
Respiratory depression and arrest
- Cheyne-stokes respirations
- Hypoventilation
- Cyanosis
CNS depression: sleep-coma-death
How would we help a patient with uncontrollable seizures?
Therapeutic overdose AKA phenobarbital coma
Anesthetic induction
Seizures can be stopped until enough serum levels of anticonvulsant drugs are achieved
What are Benzodiazepines? What are their uses?
The most commonly prescribed sedative-hypnotic drug or anxiolytic
Favourable side effect profile
Efficacy high
Safety
Examples of long-acting benzos are…
chlordiaZEpoxide
fluraZEpam
cloraZEpate
diaZEpam
Examples of intermediate-acting benzos are…
alprazolam
clonazepam
lorazepam
oxazepam
Examples of short-acting benzos are…
midazolam
triazolam
9 Indications for benzodiazepines include…
Sedation
Sleep induction(insomnia)
Skeletal muscle relaxation
Anxiety relief
Treatment of alcohol withdrawal
Agitation
Depression
Epilepsy
Balanced anesthesia
Name 6 potential side effects of benzodiazepines
Headache
Drowsiness
Lethargy
Paradoxical excitement
Hangover effect
*Can be mild and frequent
Benzodiazepines should be administered ___ to ___ minutes before sleep time
15-30
Most benzodiazepines cause what? Which benzodiazepine is the exception?
REM rebound - tired next day
Flurazepam
T/F clients can drink alcohol and other CNS depressants while on a benzodiazepine
False
It may take how many weeks before noticing improved sleep on benzodiazepines?
2-3
On discontinuation of benzodiazepines, what can happen?
Rebound insomnia
Why should safety be taught to clients on benzodiazepines?
It can cause drowsiness and dizziness
Nurses should monitor what for clients on benzodiazepines?
Monitor side effects and therapeutic effects
Name 4 potential therapeutic effects of benzodiazepines
Increased ability to sleep
Fewer awakenings
Shorter sleep-induction times
Improved sense of well-being
