25.01 Sedatives-Hypnotics

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Overview

  1. CNS depressants used for insomnia, anxiety, apprehension. Should only be used for short-term therapy.
  2. May also be used for sedation/anesthesia

Nursing Points

Nursing Considerations

  1. Use lowest dose necessary to achieve desired effects
  2. Use extreme caution if patient has a history of substance abuse (does benefit outweigh risk?)
  3. Avoid driving, ETOH
  4. Use caution in patients at risk for suicide
  5. For sleep
    1. Take approximately 30 min before desired effect
    2. Ensure patient has a full 8 hours available to sleep
    3. May continue to feel effects after awakening
    4. Diprivan – prevents REM sleep
  6. Tolerance may develop; use caution
    1. Require higher and higher doses
  7. Watch for overdose, withdrawal
  8. Should taper down; don’t abruptly D/C

Examples

  1. Barbiturates
    1. Phenobarbital
    2. Pentobarbital
  2. Anesthetic
    1. Diprivan
  3. NMDA Antagonist
    1. Ketamine

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