Hypnotics miscellaneous

SUM MARY DRUG TABLE SEDATIVES AND HYPNOTICS MISCELLANEOUS... 

Discuss the uses, general drug actions, adverse reactions, contraindications, precautions, and interactions of the barbiturates and miscellaneous sedatives and hypnotics. 

Sedatives and hypnotics may be divided into two classes barbiturates and miscellaneous sedatives and hypnotics. The barbiturates are divided into several groups, depending on tiieir duration of action ... 

Miscellaneous or nonbarbiturate sedatives and hypnotics have essentially the same mode of action as the barbiturates, that is, they depress the CNS. However,... 

Like the barbiturates, the miscellaneous drugp sedative or hypnotic effects diminish after approximately 2 weeks. Ffersons taking these dragp for periods longer than 2 weeks may have a tendency to increase the dose to produce the desired effects (eg, sleep, sedation). Physical and psychological dependence may occur, especially after prolonged use of high doses. However, their addictive potential appears to be less than that of the... 

Although the use of barbiturates and miscellaneous sedatives and hypnotics for sedation has largely been replaced by the antianxiety drugs (see Chap. 30), they occasionally may be used to provide sedation before certain types of procedures such as cardiac catheterization or the administration of a local or general anesthesia Sedative doses usually given during daytime hours, may be used to treat anxiety and apprehension. Fhtients with chronic disease may require sedation, not only to reduce anxiety, but also as an adjunct in the treatment of their disease... 

Paraldehyde, a miscellaneous sedative and hypnotic, may be used to treat delirium tremens and other psychiatric conditions. In addition, some barbiturates are used as anticonvulsants (see Chap. 28). 

Adverse reactions associated with administration of the miscellaneous sedatives and hypnotics vary depending on the drug used. Common adverse reactions include dizziness, drowsiness, headache, and nausea Other adverse reactions that may be seen with the administration of miscellaneous sedatives and hypnotics are listed in the Summary Drug Table Miscellaneous Sedatives and Hypnotics. 

All dragp entering the body ultimately leave the body. Some leave virtually unchanged, whereas others are transformed into other, less-potent chemicals or compounds detoxified (to make nontoxic or not harmful) before they are eliminated. Barbiturates and miscellaneous sedatives and hypnotics are detoxified by the liver... 

Because narcoticanalgesicsdepressthe CNS(see Chap. 19), the nurse should not administer a barbiturate or miscellaneous sedativesand hypnoticsapproximately 2 hoursbefore or after administration of a narcoticanalgesic or other CNS depressant. If the time interval between administration of a narcotic analgesic and a sedative or hypnotic is less than 2 hours the patient may experien ce severe respiratory depres-son, bradycardia, and unresponsiveness. 

Before administering a barbiturate or miscellaneous sedative and hypnotic, the nurse takes and records the patient s blood pressure, pulse, and respiratory rate In addition to the vital signs, the nurse assesses the following patient needs. 

Educating the Patient and Family hi educating the patient and family about barbiturates and miscellaneous sedatives and hypnotics, several general points must be considered, as well as teaching about two common abuses of these drugp. 

To facilitate comparison, the products are divided into the following 2 groups Miscellaneous nonbarbiturates and benzodiazepines. Although sedative doses can be given, these agents primarily are intended to be hypnotics. 

Sedatives (also called hypnotics, sedative-hypnotics, minor tranquilizers, antianxiety agents) Secobarbital (barbiturate) Glutethimide (nonbarbiturate hypnotic) Diazepam (benzodiazepine antianxiety agent) Chloral hydrate (miscellaneous hypnotic) alcohol ( substance )... 

Miscellaneous adverse effects reported with the various BZD hypnotics are listed in Table 12-12. 

TABLE 12-12. Miscellaneous adverse effects reported with benzodiazepine hypnotics... 

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