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Sedation and antipsychotics. Rachel Shynn Clinical Nurse Educator Community Mental Health. Definition. se·da·tion 1.the calming of mental excitement or abatement of physiological function, esp. by the administration of a drug. 2. the state so induced. http://dictionary.reference.com/.
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Sedation and antipsychotics Rachel Shynn Clinical Nurse Educator Community Mental Health
Definition se·da·tion 1.the calming of mental excitement or abatement of physiological function, esp. by the administration of a drug. 2. the state so induced. http://dictionary.reference.com/
Sedation • Sedation is associated with both newer and traditional antipsychotics. • Tends to be more pronounced at the initiation of therapy or upward dose titration. • Starting at low doses and stepping up the dose slowly can reduce the impact. • Patients should be warned to expect sedation in the early stages of treatment Therapeutic guidelines psychotropic, version 5. 2003.
Sedation • Sedation is divided in 3 areas: • Sedation for the acutely disturbed client. • Sedation as a adverse effect. • Sedatives as individual agents
Acutely disturbed client • In most cases the urgent need with acutely disturbed patient is to achieve sedation to: • Reduce the risk of the pt harming themselves or others. • Reduce agitation, acute psychotic symptoms. • Allow diagnostic assessment to proceed • Allow transport to an appropriate treatment setting
Sedation as a adverse effect • All antipsychotic drugs, if given in sufficiently high doses, have sedative effects. • Antipsychotics can cause sedation within, and even in some cases below, the optimal therapeutic range. • These effects are often temporary, Need to assure the pt that the degree of sedation is likely to decline over 1-2 weeks. Therapeutic guidelines psychotropic, version 5. 2003.
Continue • If the degree of sedation is unacceptable- pt safety and well being, then reduce dose and or changing to a less sedating drug.
Most sedating • The most sedating of the commonly used drugs are • Clozapine • chlorpromazine • Olanzepine • Quetiapine • and Zuclopenthixol.
Sedatives as individual agents. • Anxiolytics and Hypnotics • Benzodiazepines- eg Clonazepam, diazepam, lorazeapm, nitrazepam, temazepam, alprazolam. • These are mainly effective in relieving anxiety symptoms and will induce sleep if given in larger doses. • Drowsiness is a common initial reaction • psychomotor performance may be impaired • also given for drug withdrawal. Mims online
Nursing implications • After sedation has been achieved (acutely disturbed and -ve adverse effects) pt may need to be: • monitored closely (+ Calm and supportive) • Vital signs • monitored for other adverse effects-respiratory depression, excessive sedation, dystonic reaction such as choking). • Legal implications- Poisons act etc Management of mental disorders, Volume 2. WHO: Fourth edition.