Download Chapter 26 - Ukiah Adult School

SEDATIVES AND
HYPNOTICS
Week 19
SEDATIVE
A drug that produces a relaxing, calming
effect; usually given in the daytime
HYPNOTIC
A drug that induces sleep
Sleep
• Two phases: REM and NREM
• Four stages of NREM: I- IV
• Insomnia:
• Difficulty falling asleep
• Difficulty maintaining sleep
• Treatment of insomnia is cause dependent
• Non-drug therapy
• Decrease caffeine intake
• Exercise
• Avoid day time napping
• Light therapy
• Drug therapy
Hypnotics and Sedatives
• Barbiturates
• Benzodiazepines
• Non-benzodiazipines
• Antihistamines
Antihistamines
• Diphenhydramine (Benedryl)
• Doxylamine (Unisom)
Benzodiazepines
• First drug of choice for short-term treatment of insomnia
• estazolam
• flurazepam (Dalmane)
• quazepam (Doral)
• temazepam (Restoril)
• triazolam (Halcion)
Barbiturates
• Act to depress the central nervous system (CNS)
• Reduces the amount of time in the rapid eye
movement (REM) stage
• Abrupt withdrawal may cause dreaming,
nightmares, or insomnia
• Low therapeutic index, overdose results in death
• Long half-life results in “hang-over”
• pentobarbital (Nembutal)
• secobarbital (Seconal)
Barbiturates
• Uses
• Seizure disorders: phenobarbital and mephobarbital
• Induction of anesthesia: thiopental
• Insomnia
Miscellaneous Drugs
• Action—depress CNS
• Lesser effect on respiratory tract
• Addictive potential appears less than with the barbiturates
• Chloral Hydrate
• mepobromate
• paraldahyde
• zolpidem (Ambien)
• zaleplon (Sonata)
• eszopiclone (Lunesta)
• dexmedetomidine (Precedex)
Sedatives and Hypnotics
• Have addictive potential
• Effects diminish after approximately 2 weeks
• Physical and psychologic dependence may occur
GERONTOLOGIC
ALERT
Older adults may require smaller dose
because the older adult is at greater
risk to develop oversedation,
confusion, ataxia
NURSING ACTION
Monitor elderly patient frequently for
excitement, CNS depression, and confusion.
NURSING ALERT
Do not administer a sedative or
hypnotic 2 hours before or after
administration of a narcotic analgesic
or other CNS depressant
Alternative medicines
• Valerian
• Melatonin
• Chamomile
• Passionflower
• Lemon balm
• Lavender
• Richard Howard is a 34-year-old African American man.
He presents to the physician’s office with a chief
complaint of insomnia. The physician writes Mr. Howard a
prescription for temazepam (Restoril) 15 mg at bedtime as
needed for sleep.
• • 1.
Is temazepam (Restoril) a sedative or hypnotic?
• 2.
What is the difference between a sedative and a
hypnotic?
• • 3.
What information should be included in the nurse’s
teaching plan for educating Mr. Howard about his
medication?
• 1. Sedative is a drug that induces drowsiness or
sleep.
• 2. Barbiturates have little or no analgesic
action.
• 3. Hypnotics are given at night or at the hour of
sleep.
• 4. Hypnotics are used for post operative
sedation.
• 5. Barbiturates are known to depress the central
nervous system.
• 1. A child born to a mother taking benzodiazepines may
•
•
•
•
develop __________symptoms during the postnatal
period.
2. A ___________or miscellaneous sedative and
hypnotic can cause drug dependency.
3. To promote the effects of the sedative or hypnotic
drug, the patient is discouraged from drinking beverages
containing ________.
4. Eszopiclone is an example of __________.
5. A common gastrointestinal (GI) reaction of sedative
and hypnotic drugs is _______.