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Sedatives & Hypnotics

Sedatives & Hypnotics. C. Matthews MSN, RN, CNE Fall 2013. NOTE! I’ve figured out how to put the youtube videos on the ppp correctly!! The videos on this power point presentation will be much easier than the ones on the antipsychotic ppp !. Terminology. 160) Hypnotic : induce sleep

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Sedatives & Hypnotics

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  1. Sedatives & Hypnotics C. Matthews MSN, RN, CNE Fall 2013

  2. NOTE! I’ve figured out how to put the youtube videos on the ppp correctly!! The videos on this power point presentation will be much easier than the ones on the antipsychotic ppp!

  3. Terminology • 160) • Hypnotic: induce sleep • NOT this kind of “hypnotic” • http://www.youtube.com/watch?v=TEdxA4SR5yU • THIS kind of hynotic • http://www.youtube.com/watch?v=gmpVY89fLF0

  4. Terminology Sedative: sedate or relax a patient (Adams, Holland & Urban, pg. http://www.youtube.com/watch?v=N6cV-prZwMw

  5. Drugs used to relax • Benzodiazepines • Examples: lorazepam (Ativan); alprozolam (Xanax); clonazepam (Klonopin); diazepam (Valium); clorazepate (Tranxene) • Barbituates • Pentobarbital sodium (Nembutal); secobarbital (Seconal); amobarbital (Amytal);

  6. How Sedatives Work • They manipulate the actions of neurotransmitters > gamma-aminobutyric acid (GABA) in particular • GABA is a natural inhibitory neurotransmitter found in the brain. • These drugs “intensify the effect” (Adams, et al. page 163) of GABA • A consequence = Central nervous system (CNS) depression

  7. Because these drugs are CNS depressants – use caution if they are combined with other CNS depressants • Teach the patient not to drink alcohol while taking these drugs. • If patient is on Ativan and Digoxin, nurse must be aware the combination may increase serum digoxin levels.

  8. Hypnotics: Examples • Benzodiazepines: • estazolam (Prosom); flurazepam (Dalmane); quazepam (Doral); temazepam (Restoril); triazolam (Halcion) • Benzodiazepines are Schedule IV drugs. • Barbituates: • mephobarbital (Mebaral); phenobarbital (Luminal) • Several barbituates are Schedule II drugs. • Other CNS depressants: • zaleplon (Sonata); eszopiclone (Lunesta); zolpidem (Ambien)

  9. Hypnotics Patients over 65 y/o taking benzodiazepines –- RN should caution them about over sedation, confusion and impaired mobility. FALL precautions are appropriate. Withdrawal syndrome from barbituates can be severe – do not take or discontinue without MD supervision. Barbituates can stimulate their own metabolism and can stimulate enzymes to break down other medications. Concurrent prescription dosage strength and times may need to be adjusted.

  10. References • Adams, M., Holland, N. & Urban, C. (2014). Pharmacology for nurses, a pathophysiologic approach. (4th ed.). Pearson, Boston.

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