SEDATIVES AND HYPNOTICS

1
SEDATIVES AND HYPNOTICS

• SEDATIVES- Reduce nervousness, excitability, and
  irritability without sleep
• HYPNOTICS- Cause sleep, more potent effect on CNS

2
BARBITURATES

• ACTION- Inhibit nerve impulse transmission
• EFFECTS- Dose related, low dosed act as
  sedatives, high doses act as hypnotics
• SEIZURES- Raise convulsive threshold so treat or
  prevent seizures

3
BARBITURATES SUDE EFFECTS AND ADVERSE EFFECTS

• EXCESSIVE CNS DEPRESSION
• HYPERSENSITIVITY REACTIONS
• EXCITEMENT
• RESPIRATORY DEPRESSION AND HYPOTENSION
• TOLERANCE
• DEPENDENCE
• CONVULSIONS AND DEATH

4
NURSING IMPLICATIONS FOR BARBITURATES

• DO NOT MIX WITH meperidine HCL (DEMEROL)
• INTERACT WITH MANY OTHER DRUGS
• CAUSES TOLERANCE AND DEPENDENCY
• SE - DEPRESSION
• TEACHING- SEDATION EFFECTS DRIVING, DANGEROUS
  MACHINERY, OTHER CNS DEPRESSANTS

5
BENZODIAZEPINES

• CONTROL AGITATION AND ANXIETY
• HYPNOTIC EFFECTS - USED FOR SLEEP INDUCTION ,
  DOES NOT SUPPRESS REM SLEEP
• FEW AND MILD SIDE EFFECTS- INVOLVE CNS

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NURSING IMPLICATIONS FOR HYPNOTICS AND SEDATIVES

• CHECK PATIENTS HISTORY
• DETERMINE IF ON OTHER CNS DEPRESSANTS OR PRONE TO
  PROBLEMS BECAUSE OF AGE OR HEALTH STATUS
• CHECK FOR POSSIBLE DRUG INTERACTIONS
• ASSESS VITAL SIGNS
• CHECK FOR SIDE EFFECTS

7
PATIENT TEACHINGBENZODIAZEPINES BARBITURATES

• TAKE ONLY AS PRESCRIBED
• AVOID DRIVING AND OPERATING HEAVY MACHINERY
• AVOID TAKING OTHER CNS DEPRESSANTS
• CHECK BEFORE TAKING OTHER OTC MEDICATIONS
• NEVER ABRUPTLY STOP TAKING

8
ANTIANXIETY DRUGS

• BARBITURATES- Many undesirable side effects
• CARBAMATES- Meprobamate
• ANTIHISTAMINES- Vistaril
• BENZODIAZEPINES- Popular Side Effects-
  accumulate, have a long half-life, withdrawal may
  be problematic
• MONOAMINE OXIDASE INHIBITORS, BUSPIRONE,
  TRICYCLIC TETRACYCLIC ANTIDEPRESSANTS

9
ANTICONVULSANTS

• ACTION
• BARBITURATES
• HYDANTOINS (Dilantin)
• BENZODIAZEPINES
• VALPROIC ACID (Depakene, Depakote)
• CARBAMAZEPINE (Tegretol)

10
NURSING IMPLICATIONS AND PATIENT TEACHING FOR
DILANTIN

• Noncompliance
• Dilantin Side Effects- gingival hyperplasia and
  anemia
• Dilantin Phenobarbital are often given together
• Give Dilantin slow IV push
• Not to be taken by pregnant women
• Monitor blood level