Sedatives-Hypnotics

Question 1

What should you assess before giving a sedative or hypnotic?

Answer 1

Vitals
Sleep pattern
Environmental control- temp, lights, noise
Caffeinated products
Respiratory status

Question 2

What is the action of Barbiturates?

Answer 2

Reduce nerve impulses traveling to the cerebral cortex

Suppress REM and stages 3 & 4

Question 3

When are Barbiturates used?

Answer 3

Sedative-hypnotics

Anticonvulsants

Question 4

What are the side effects of Barbiturates as sedative-hypnotics?

Answer 4

CNS depression, hangover effect, hypotension, respiratory distress, dependence, rebound phenomenon, tolerance

Question 5

What is an interaction that Barbiturates have?

Answer 5

Enzyme inducers- Warfarin

Question 6

What is the action of Benzodiazepines?

Answer 6

Binds to GABA receptors

Question 7

When are Benzodiazepines used?

Answer 7

Sedative-hypnotic, anti anxiety, anticonvulsants

Question 8

What are the side effect of Benzodiazepines?

Answer 8

Hypotension, respiratory depression, hangover effect, retrograde amnesia, dependence, tolerance

Question 9

What is an interaction that Benzodiazepines have?

Answer 9

Alcohol and other CNS depressants- additive effect

Question 10

What enhances the metabolism of Benzodiazepines?

Answer 10

Smoking

Question 11

What are Benzodiazepines contraindicated in?

Answer 11

Drug allergy
Severe respiratory disorders
Pregnancy
Decreased Level of consciousness

Question 12

What do Benzodiazepines have a decreased effect with?

Answer 12

CNS stimulants- alcohol, meth

Barbiturates

Question 13

What are some nursing considerations of Benzodiazepines?

Answer 13

Sleep apnea- makes worse
Cardiac and respiratory function
Mental status
Use of alcohol or CNS depressants
Liver, renal, CBC labs

Question 14

Should Benzodiazepines be used for long or short term use?

Answer 14

Short term use

Question 15

What is the action of NONbarbiturates or NONbenzodiazepines?

Answer 15

Bind to type 1 GABA receptors in the CNS

Question 16

When are NONbarbiturates or NONbenzodiazepines used?

Answer 16

Produce sleep

Question 17

What are the side effects of NONbarbiturates or NONbenzodiazepines?

Answer 17

CNS depression, muscle and joint pain, drowsiness, dizziness, headache

Question 18

What are the advantages of using NONbarbiturates or NONbenzodiazepines?

Answer 18

Minimal hangover effect
No rebound insomnia
Doesn’t interfere with REM sleep
Short half life

Question 19

What is an interaction that NONbarbiturates or NONbenzodiazepines have?

Answer 19

CNS depressants and alcohol

Question 20

What is the action of Melatonin?

Answer 20

Non-sedating, helps relax and get ready to sleep

Question 21

When is Melatonin used?

Answer 21

Treatment of insomnia, with difficulty with sleep onset

Question 22

What are the side effects of Melatonin?

Answer 22

Angioedema, hallucinations, dizziness

Question 23

What are the drug interactions of Melatonin?

Answer 23

Increases depression with other CNS depressants

Question 24

Who should avoid taking Melatonin?

Answer 24

Severe hepatic impairment patients

Question 25

When should Melatonin be taken?

Answer 25

30 minutes prior to bedtime

Question 26

What is some client and family teaching related to sedatives and hypnotics?

Answer 26

Sleep diary
Avoid alcohol or CNS depressants
Dependency or withdrawal
Avoid driving
Caffeine has effects on medications
Do not keep at bedside