a. Long-Acting Sedatives. The long-acting sedatives have a duration of action
of 6 to 8 hours. When used as hypnotics, they should induce a sleep of at least 4 to 6
hours, followed by a hangover.
(1) Phenobarbital (Luminal). This drug is widely used as a sedative. In
addition, it is used to induce sleep and to treat the symptoms of epilepsy, particularly
grand mal epilepsy. Most other barbiturates are not effective in the treatment of
epilepsy. This drug is less expensive than the other long-acting sedatives discussed
here, but in comparable doses its therapeutic effectiveness is at least equivalent.
(2) Chlordiazepoxide hydrochloride (Librium). A distinctive trait of
chlordiazepoxide is the slowness with which it is excreted from the body; this gives it a
longer duration of action than phenobarbital. Otherwise, its effects are similar to those
of phenobarbital in comparable doses.
Oxazepam (Serax). This drug is very similar to chlordiazepoxide above.
Flurazepam (Dalmane). This drug is very similar to chlordiazepoxide.
b. Intermediate-Acting Sedative-Hypnotics. These drugs produce sedation
for 4 to 6 hours. Like short-acting sedatives, these drugs have a greater potential for
abuse than do the long-acting sedatives.
(1) Sodium amobarbital (Amytal Sodium). This drug is typical of the
intermediate-acting sedative-hypnotics. Doses may be varied to produce anything from
mild sedation to preanesthetic hypnosis.
(2) Meprobamate (Equanil; Miltown). This drug is nearly equivalent in its
effects to amobarbital.
(3) Glutethimide (Doriden). A few clients experience convulsions while
using this drug. When used as a hypnotic, glutethimide may cause a hangover.
(4) Diazepam (Valium). Though this drug is very similar chemically to
chlordiazepoxide (Librium), its effect begins more quickly and its action is of shorter
(5) Lorazepam (Ativan). This drug is chemically similar to both diazepam
and chlordiazepoxide. It has a short duration of action and onset of action.
c. Short-Acting Hypnotics. The short-acting sedative-hypnotics are used
almost exclusively as hypnotics. Since the duration of action is only 2 to 4 hours, a
client using one of these drugs as a sedative might become psychologically dependent
on it because of the frequency with which his anxiety or discomfort is rapidly relieved by
taking it. An advantage of these short-acting drugs as hypnotics is that after a full