Sedatives-Hypnotics Flashcards
What should you assess before giving a sedative or hypnotic?
Vitals Sleep pattern Environmental control- temp, lights, noise Caffeinated products Respiratory status
What is the action of Barbiturates?
Reduce nerve impulses traveling to the cerebral cortex
Suppress REM and stages 3 & 4
When are Barbiturates used?
Sedative-hypnotics
Anticonvulsants
What are the side effects of Barbiturates as sedative-hypnotics?
CNS depression, hangover effect, hypotension, respiratory distress, dependence, rebound phenomenon, tolerance
What is an interaction that Barbiturates have?
Enzyme inducers- Warfarin
What is the action of Benzodiazepines?
Binds to GABA receptors
When are Benzodiazepines used?
Sedative-hypnotic, anti anxiety, anticonvulsants
What are the side effect of Benzodiazepines?
Hypotension, respiratory depression, hangover effect, retrograde amnesia, dependence, tolerance
What is an interaction that Benzodiazepines have?
Alcohol and other CNS depressants- additive effect
What enhances the metabolism of Benzodiazepines?
Smoking
What are Benzodiazepines contraindicated in?
Drug allergy
Severe respiratory disorders
Pregnancy
Decreased Level of consciousness
What do Benzodiazepines have a decreased effect with?
CNS stimulants- alcohol, meth
Barbiturates
What are some nursing considerations of Benzodiazepines?
Sleep apnea- makes worse Cardiac and respiratory function Mental status Use of alcohol or CNS depressants Liver, renal, CBC labs
Should Benzodiazepines be used for long or short term use?
Short term use
What is the action of NONbarbiturates or NONbenzodiazepines?
Bind to type 1 GABA receptors in the CNS
When are NONbarbiturates or NONbenzodiazepines used?
Produce sleep
What are the side effects of NONbarbiturates or NONbenzodiazepines?
CNS depression, muscle and joint pain, drowsiness, dizziness, headache
What are the advantages of using NONbarbiturates or NONbenzodiazepines?
Minimal hangover effect
No rebound insomnia
Doesn’t interfere with REM sleep
Short half life
What is an interaction that NONbarbiturates or NONbenzodiazepines have?
CNS depressants and alcohol
What is the action of Melatonin?
Non-sedating, helps relax and get ready to sleep
When is Melatonin used?
Treatment of insomnia, with difficulty with sleep onset
What are the side effects of Melatonin?
Angioedema, hallucinations, dizziness
What are the drug interactions of Melatonin?
Increases depression with other CNS depressants
Who should avoid taking Melatonin?
Severe hepatic impairment patients
When should Melatonin be taken?
30 minutes prior to bedtime
What is some client and family teaching related to sedatives and hypnotics?
Sleep diary Avoid alcohol or CNS depressants Dependency or withdrawal Avoid driving Caffeine has effects on medications Do not keep at bedside
