Learning Center Articles

Sedative-Hypnotics

Sedative-Hypnotics

Indications

  • Short-term management of various anxiety states and treatment of insomnia; selected agents are used as anticonvulsants, as preoperative sedatives, and to reduce anxiety associated with alcohol withdrawal.

Action: Depression of the C N S

  • Exception: Ramelteon’s sleep-promoting properties are the result of agonist activity on selective melatonin receptors.

Contraindications

  • Contraindicated in known hypersensitivity, pregnancy, and lactation, and in severe hepatic, cardiac, respiratory, or renal disease.

Precautions

  • Caution is advised with clients with hepatic, cardiac, renal, or respiratory insufficiency.
  • Caution is also advised with those who are suicidal and those who have been addicted to drugs.

Drug Interactions

Interacting Drugs

Adverse effects

Barbiturates

Increased effects are present when used with other medications such as MAOI, CNS depressants, valporic acid and alcohol. May cause renal toxicity when used with methoxyflurane

Benzodiazepines

Eszopiclone

Addictive effects

Zaleplon

Addictive effects

Zolpidem

Increased effects that may lead to cardiac arrhythmias

Ramelteon

Nursing diagnosis

  • Risk for injury
  • Disturbed sleep pattern/insomnia
  • Risk for activity intolerance
  • Risk for acute confusion
  • Monitor client for the side effects such as abnormal thinking and behavioral changes like aggressiveness, hallucinations, and suicidal ideations. Other effects may be sleep-driving, preparing and eating food, and making phone calls with no memory of the action.