Sedative-hypnotics are commonly referred to as sedatives and are the mildest form of central nervous system depressant. Sedative-hypnotics are given in low doses to diminish the patient's physical and mental responses without affecting the patient's consciousness.

With increased doses, the patient experiences a hypnotic effect causing the patient to fall asleep. Even higher doses of sedative-hypnotics anesthetize the patient. Such is the case of the ultra-short-acting barbiturate thiopental sodium (Pentothal) that produces anesthesia.

Sedative-hypnotics and barbituates were first used to reduce tension and anxiety. However, other medications have been developed for this use. Chronic use of any sedative-hypnotic should be avoided.

It is important to understand that sedative-hypnotics are not the same as sleep medications purchased over-the-counter such as Nytol, Sominex, Sleep-eze, and Tylenol PM. Over-the-counter sleep medications such as diphenhydramine contain an antihistamine not barbiturates to achieve sedation.

Short-acting sedative-hypnotics are ideal for patients who need assistance falling asleep but who must awaken early without experiencing a lingering aftereffect from the medication. Intermediate-acting sedative-hypnotics are useful to sustain sleep. Patients may experience residual drowsiness (hangover) after awakening.

The use of sedative-hypnotics for sleep (hypnotic) should be short term or there is a chance that the patient could become dependent on the medication or develop a tolerance. Patients who take high doses of sedative-hypnotics over long periods must gradually discontinue the medication rather than abruptly stopping the drug which can cause withdrawal symptoms. Sedative-hypnotics should not be administered to patients who have severe respiratory disorders or who are pregnant.

Before a patient is prescribed a sedative-hypnotic to aid with sleep, the patient should try non-pharmacological methods that promote sleep such as:

• Arise at a specific hour in the morning.

• Avoid heavy meals or strenuous exercise before bedtime.

• Take a warm bath, read, or listen to music before bedtime.

• Decrease exposure to loud noises.

• Avoid watching disturbing television before sleep.

• Avoid drinking a lot of fluids before sleep.

• Drink warm milk before sleep.

See sedative-hypnotic-benzodiazepine provided in the Appendix. Detailed tables show doses, recommendations, expectations, side effects, contraindications, and more; available on the book's Web site (see URL in Appendix).

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Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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