night's sleep the client is likely to experience no hangover; the action of these drugs is
completely exhausted after about 4 hours.
(1) Chloral hydrate. Sometimes, this old and very effective hypnotic is used
as a sedative. However, it occasionally causes irritation of the stomach, and it should
not be given to clients with serious heart, kidney, or liver disease.
(2) Paraldehyde. Paraldehyde is a very effective hypnotic, but it has an
unpleasant taste and some of it is exhaled from the lungs of the client. This causes an
odor more offensive to those dealing with the client than to the client himself. Since
paraldehyde is infrequently used, care must be taken to avoid the use of deteriorated
stock, which may be very acidic. Once opened, paraldehyde must be refrigerated.
(3) Sodium pentobarbital (Nembutal). Pentobarbital is the standard of the
short-acting hypnotics.
(4) Sodium secobarbital (Seconal Sodium). Both sodium pentobarbital
(above) and sodium secobarbital are effective short-acting hypnotics.
(5) Triazolam (Halcion). This drug is similar to chlordiazepoxide but has a
short onset of action and short duration. Clients are less likely to experience hangover
effects.
3-8.
PHENOBARBITAL
a. Action and Uses. Phenobarbital is a long-acting barbiturate, requiring 30 to
60 minutes to become effective and acting over a period of 6 hours or more. The drug
has many uses. It can be used as a sedative in times of mental stress or anxiety. It is
often used in conditions such as hyperthyroidism, hypertension, peptic ulcer, and
menopause. It is used as a hypnotic drug for insomnia and as an anticonvulsant in
certain kinds of epilepsy.
b. Administration. The drug can be given orally, intramuscularly, or
intravenously as indicated by the clinical situation. Unless there is specific indication for
giving the drug parenterally, the oral route is preferred. The usual dose as a sedative is
16 to 32 mg. As a hypnotic, it is given in a dose of 100 mg. Dosage as an
anticonvulsant varies with the needs of the client, but usually ranges from 16 mg to 64
mg.
c. Untoward Effects. Clients can become addicted to phenobarbital as they
can to any potent sedative-hypnotic. This drug may exert a toxic effect upon the
kidney, resulting in depressed kidney function. Overdosage may result in the typical
symptoms of shock, respiratory complications (including respiratory failure), and kidney
failure.
MD0913
3-7