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What is a sedative?
a drug that produces a relaxing calming effect; usually given in the daytime
- Usually given in daytime
- Short term use cuz highly abusive
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What is a Hypnotic?
a drug that induces drowsiness or sleep
- Usually given @ night (need 7-8hrs of sleep)
- Short term use cuz highly abusive
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What 2 classes are Sedatives & Hypnotics divided into?
- Barbituates
- NonBarbituates
- Benzodiazpines
- Nonbenzodiazpines
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What are Barbiturates?
- Depress CNS
- Reduce amt of time in REM stage
- Abrupt withdrawal may cause dreaming, nightmares, or insomnia(so taper off drug)
- Use ---insomnia, mood alterations
A/R= Most common "drunk feeling" next morning.
- Nurse:
- Don't give if respirations are less thn 10
- Don't give4 pain medications cuz doesn't alleviate pain may cause RESTLESSNESS, EXICTEMENT & DELIRIUM
- Know signs of TOXICITY especially in elderly
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Benzodiazepines & Nonbenzodiazepines
- Action: Depress CNS
- Lesser effect on respiratory tract
- Addictive potential appears less than with barbiturates
- Nonbenzodiazepines effects diminish after approx 2wks
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Sedatives & Hypnotics
- Have addictive potential
- Effects diminish after approx 2wks
- Physical and psychological dependence may occur
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Geri alert
Older adults may require smaller dose bcuz the older adult is @ greater risk 2 develop EXCITEMENT, OVERSEDATION, CONFUSION, ATAXIA
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Nursing Alert
DONT GIVE 2HRS B4 OR 2HRS AFTER NARCOTICS OR OTHER CNS DEPRESSANTS
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Can you give barbituates for pain?
HELL NO. Barbituates have no analgesic action, so the nurse does not give these drugs 4 pain and can't sleep. If given in the presence of pain, may cause restlessness, excitement, and delirium.
- Contraindicated in pts:
- Comatose peeps
- Severe respiratory problems
- Hx of drug & alcohol abuse
- Pregos or Lactating peeps
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What is barbiturate Toxicity?
May not occur until several hours after the drug is given
- SYMPTOMS:
- CNS & Respiration depression
- Constriction
- Hypotension
- Lowered body temp.
- Oliguria
- Circulatory collapse
- Coma
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What is Nursing assessment of these drugs?
Preadministration= V/S, pain level
Ongoing= V/S, has the drug helped b4, any other CNS depressants taking?
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What is the Over the counter supplement for Sedative & Hypnotics?
Melatonin a hormone produced by the pineal gland in the brain.
Used for = jet lag, improving effectiveness of immune system, antioxidant
Drowsiness may occur w/in 30mins after taking supplement
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What is the herb used for its sedative effects for mild anxiety or restlessness, or peeps w/ insomnia?
Valerian it improves overall sleep quality by shortening the length of time it takes 2 fall asleep and decreasing the number of nighttime awakenings.
can experience w/drawal syptoms
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What would the nurse teach client/family about the use of these drugs?
- Short term use
- If drug appears ineffective don't increase dosage until u talk 2 the DRDon't drink alcohol 2hrs b4 or 8hrs after
- Impairs mental & physical abilities so don't DRIVE or any heavy machinery
- Becareful when getting out of bed, keep a dim light on remove clutter
- Don't take if your prego or lactating
- Dont use OTC cold, cough, or allergy drugs unless checked w/ DRDon't take Zolpidem w/ high fat meal or snack cuz fat interferes w/ absorption of drug
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