Sedativehypnotics

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Sedative-hypnotics

• Sedative quiets patient, gives a feeling of
  relaxation and rest
• Not necessarily accompanied by sleep

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Sedative- hypnotics

• Hypnotic produces sleep

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Sedative-hypnotics

• CLASSIFIED INTO 3 GROUPS
• 1. BARBITUATES
• 2. BENZODIAZEPINES
• 3. MISCELLANEOUS

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SEDATIVE-HYPNOTICS

• ACTIONS
• Depress CNS function
• Increase total sleeping time
• Decreases REM sleep
• Paradoxic excitement following admin. in elderly

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Sedative-hypnotics

• SIDE EFFECTS
• Dependence
• Hang over drowsy
• Sedation lethargy
• S/S withdrawl if rapidly discontinued

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Nonpharmacologic Interventions

• Sleep patern
• Environmental control
• Exercise
• Nutrition
• Establish bedtime routine
• Avoid actions that wake patient

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Teaching

• Dont use alcohol
• Do not operate equipment
• Do not drive
• Estrogen alternate birth control used
• DO NOT RAPIDLY DISCONTINUE
• SHORT-TERM USE ONLY

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DRUGS USED FOR ANXIETY DISORDERS

• ANXIETY DISORDERS
• The most frequently encountered mental disorder
  in clinical practice
• A component of many medical illnesses and
  psychiatric disorders

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ANTIANXIETY MEDICATIONS

• ANXIOLYTICS OR TRANQUILIZERS
• BENZODIAZEPINES- most common

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Benzodiazepines

• Most commonly used
• Ex alprazolam (Xanax)
• lorazepam (Ativan)
• diazepam (Valium)

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Benzodiazepines

• SIDE EFFECTS
• CNS depression
• Drowsiness, decreased alertness
• NURSING IMPLICATIONS
• Provide safety
• Assist with ambulation

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DRUGS USED FOR MOOD DISORDERS

• USES
• Mood disorders (affective disorders)
• Abnormal feelings of depression or euphoria
• Pt.s have a change in brain neurotransmitters
  (dopamine,serotonin, histamines)
• Unexplained negative life events, endocrine
  abnormalities,genetic factors

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Antidepressants

• All medications effect neurotransmitters
• Drug treatment not immediately effective (1-4
  wks)

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MAOIS

• Monoamine Oxidase Inhibitors
• Axn block metabolic destruction of
• Epinephrine, norepinephrine, serotonin
• Elevate mood and alertness

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MAOIS

• SIDE EFFECTS
• Orthostatic hypotension
• Drowsiness, sedation
• Anticholinergic effects
• Many drug interactions
• HTN CRISES

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MAOIS

• Hypertensive crisis
• Potential complication
• Avoid foods rich in tyramine
• Cheese, wine, pickled foods

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TRICYCLIC ANTIDEPRESSANTS

• ACTIONS
• Prolong action of norepinephrine, dopamine, and
  serotonin

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TRICYCLIC ANTIDEPRESANTS

• Side effects
• Anticholinergic activity
• Orthostatic hypotension

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Selective Seratonin Reuptake Inhibitors

• ACTION
• INHIBIT REUPTAKE AND DESTRUCTION OF SEROTONIN

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SSRIS

• Selective serotonin reuptake inhibitors
• Most widely used antidepressants
• Advantages no anticholinergic effect
• No cardiovascular effect
• Improvement in mood in a few days
• Therapeutic levels several weeks

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SSRIS

• SIDE EFFECTS
• Restlessness,agitation,anxiety,insomnia
• Sedative effects
• GI effects

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SSRIS

• EXAMPLES
• Prozac
• Paxil
• Zoloft

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Antimanic agent

• LITHIUM
• ACTION replaces intracellular and intraneuronal
  sodium, stabilizing the neuronal membrane

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LITHIUM

• USED TO TX. ACUTE MANIA OR PROPHYLAXIS OF
  RECURRENT MANIA IN EPISODES OF BIPOLAR DISORDER.

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HCP IMPLICATIONS

• Narrow therapeutic range
• Maintain normal sodium intake
• 10-12 glasses of water a day
• Toxicity lethargy, weakness, persistant
  vomiting, profuse diarrhea, muscle twitching
• Take as prescribed, same time each day
• Labs checked before started on Lithium