Download Sedation and antipsychotics

Sedation and
antipsychotics
Rachel Shynn
Clinical Nurse Educator
Community Mental Health
Definition
se·da·tion
1.the calming of mental excitement or abatement
of physiological function, esp. by the
administration of a drug.
2. the state so induced.
http://dictionary.reference.com/
Sedation
Sedation is associated with both newer and
traditional antipsychotics.
Tends to be more pronounced at the initiation of
therapy or upward dose titration.
Starting at low doses and stepping up the dose
slowly can reduce the impact.
Patients should be warned to expect sedation in
the early stages of treatment
Therapeutic guidelines psychotropic, version 5. 2003.
Sedation
Sedation is divided in 3 areas:
Sedation for the acutely disturbed client.
Sedation as a adverse effect.
Sedatives as individual agents
Acutely disturbed client
In most cases the urgent need with acutely
disturbed patient is to achieve sedation to:
Reduce the risk of the pt harming themselves or
others.
Reduce agitation, acute psychotic symptoms.
Allow diagnostic assessment to proceed
Allow transport to an appropriate treatment setting
Sedation as a adverse
effect
All antipsychotic drugs, if given in sufficiently
high doses, have sedative effects.
Antipsychotics can cause sedation within, and
even in some cases below, the optimal
therapeutic range.
These effects are often temporary, Need to
assure the pt that the degree of sedation is likely
to decline over 1-2 weeks.
Therapeutic guidelines psychotropic, version 5. 2003.
Continue
If the degree of sedation is unacceptable- pt
safety and well being, then reduce dose and or
changing to a less sedating drug.
Most sedating
The most sedating of the commonly used drugs
are
Clozapine
chlorpromazine
Olanzepine
Quetiapine
and Zuclopenthixol.
Sedatives as individual
agents.
Anxiolytics and Hypnotics
Benzodiazepines- eg Clonazepam, diazepam,
lorazeapm, nitrazepam, temazepam, alprazolam.
These are mainly effective in relieving anxiety
symptoms and will induce sleep if given in larger
doses.
Drowsiness is a common initial reaction
psychomotor performance may be impaired
also given for drug withdrawal.
Mims online
Nursing implications
After sedation has been achieved (acutely
disturbed and -ve adverse effects) pt may need
to be:
monitored closely (+ Calm and supportive)
Vital signs
monitored for other adverse effects-respiratory
depression, excessive sedation, dystonic reaction
such as choking).
Legal implications- Poisons act etc
Management of mental disorders, Volume 2. WHO: Fourth edition.