Sedative Hypnotic Drugs | NCLEX RN Review

Summary

This video tutorial explains sedatives, hypnotics, and insomnia management. It covers the differences between sedatives (used for relaxation) and hypnotics (used to induce sleep), their action on the CNS through GABA, and common treatments for insomnia. It discusses benzodiazepines, nonbenzodiazepine hypnotics, and their potential side effects, including dependence and withdrawal. The video also emphasizes the importance of proper sleep hygiene and lifestyle changes in managing insomnia. Additionally, it provides patient teaching guidelines on the safe use of sedative-hypnotic drugs and introduces herbal supplements like melatonin and valerian for improving sleep quality.

Takeaways

• 😀 Sedatives are drugs used to promote relaxation and relieve anxiety, while hypnotics are higher doses of sedatives designed to induce sleep.
• 😀 Both sedatives and hypnotics are CNS depressants that enhance the activity of GABA, a neurotransmitter responsible for drowsiness and sleep maintenance.
• 😀 Insomnia is characterized by difficulty falling or staying asleep and can be caused by stress, anxiety, pain, illness, lifestyle changes, and medications.
• 😀 Acute insomnia lasts for a short period (up to a few weeks), while chronic insomnia persists for longer than a month.
• 😀 The main drugs used to treat insomnia are benzodiazepines and non-benzodiazepine hypnotics, with each class having distinct benefits and risks.
• 😀 Benzodiazepines are effective for short-term insomnia treatment but come with risks of dependence, withdrawal symptoms, and excessive sedation.
• 😀 Non-benzodiazepine hypnotics like Lunesta, Sonata, Rozerem, and Ambien are alternatives with potentially fewer dependence risks and varying durations of use.
• 😀 Common side effects of sedative-hypnotic drugs include daytime drowsiness, dizziness, impaired coordination, and memory issues. These should not be combined with alcohol or other CNS depressants.
• 😀 Non-drug measures like maintaining a consistent sleep schedule, avoiding caffeine and alcohol, and creating a comfortable sleep environment should be prioritized for insomnia treatment.
• 😀 Herbal supplements like melatonin and valerian root can aid in improving sleep quality, with melatonin being particularly useful for regulating the sleep-wake cycle.

Q & A

What are sedatives and how do they work?

Sedatives are drugs that promote relaxation and are used to relieve irritability or anxiety. They work by increasing the activity of GABA (gamma-aminobutyric acid), a neurotransmitter in the brain, which promotes a calming effect and can lead to drowsiness.

What is the difference between sedatives and hypnotics?

Sedatives are generally used to promote relaxation, while hypnotics are higher doses of sedatives specifically designed to induce sleep. Both types of drugs work by increasing GABA activity in the brain, which helps manage sleep-related issues.

What is insomnia and what are its causes?

Insomnia is the prolonged difficulty of falling asleep or staying asleep long enough to feel rested. It can be caused by a variety of factors, including poor sleep habits, depression, anxiety, pain, illness, lifestyle or environmental changes, and certain medications.

What is the difference between acute and chronic insomnia?

Acute insomnia lasts from one night to a few weeks, while chronic insomnia persists for longer than a month. Both forms of insomnia result in inadequate sleep, but chronic insomnia is typically more persistent and challenging to treat.

What are benzodiazepines and how are they used in insomnia treatment?

Benzodiazepines are a class of drugs that depress the central nervous system (CNS). They are used to treat insomnia, especially for short-term relief. They can cause excessive sedation, physical and mental impairment, and respiratory depression, and should be avoided for long-term use due to the risk of dependence.

What are some common benzodiazepines prescribed for insomnia?

Common benzodiazepines used for insomnia include flurazepam (Dalmane), temazepam (Restoril), triazolam (Halcion), and quazepam (Doral). These medications are well absorbed orally but can lead to dependence and withdrawal symptoms if used for extended periods.

What are the potential side effects of benzodiazepines?

Side effects of benzodiazepines can include daytime drowsiness, dizziness, dependence, withdrawal symptoms, and physical problems such as an increased risk of falling, especially in older individuals. They should not be combined with other CNS depressants.

What are nonbenzodiazepine hypnotics and how do they differ from benzodiazepines?

Nonbenzodiazepine hypnotics, such as eszopiclone (Lunesta), zolpidem (Ambien), and ramelteon (Rozerem), are sedative-hypnotic agents that work similarly to benzodiazepines but are considered safer for long-term use. They have a lower risk of dependence and withdrawal compared to benzodiazepines.

What is Rozerem and how does it work?

Rozerem (ramelteon) is a nonbenzodiazepine hypnotic that binds to melatonin receptors in the CNS, helping to regulate the sleep-wake cycle and maintain circadian rhythm. It is the only non-controlled hypnotic and does not cause physical dependence.

What are some non-drug strategies for managing insomnia?

Non-drug strategies for managing insomnia include maintaining a consistent sleep schedule, avoiding naps, reducing caffeine, nicotine, and alcohol intake, limiting screen time before bed, exercising earlier in the day, and creating a comfortable sleep environment. Following a relaxing bedtime routine can also help improve sleep.

What are some herbal supplements that can aid in insomnia treatment?

Herbal supplements like melatonin and valerian can be helpful in managing insomnia. Melatonin, a natural hormone, regulates the sleep-wake cycle, while valerian acts as a sedative on the brain and nervous system to improve sleep quality.

What are the patient teaching guidelines for sedative-hypnotic drugs?

Patients should not take sedative-hypnotic drugs every night to avoid dependency and maintain effectiveness. It is important to avoid alcohol and other CNS depressants, and not perform tasks requiring alertness while drowsy. Most benzodiazepine hypnotics lose their effectiveness after 4 weeks of daily use.