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.
