Sedation Drugs

Benzodiazepines

• ex: versed, valium, Ativan

• used for alcohol associated withdrawals and DT

• monitor for resipiratory depression and hypotension

• not recommend for routine sedation due to causing longer mechanical ventilation

Propofol

• powerful milky white sedative used for mechanical ventilated patients to induce and maintain anesthesia. It is known for its rapid onset and short duration of action.

• pts can be awaken for spontaneous awaken trials, breathing trials, and neurological assessments

• NOT an analgesic

Proprofol related infusion syndrome

• metabolic acidosis, muscular weakness, rhambdolymsis, myoglobinuria, AKI, dysrhythmias,

Propofol Nursing Monitoring

• lipid based emulsion: change tubing every shift

• can increase triglycerides monitor labs

• green urine is benign effect

• monitor for respiratory depression and pain

Clonidine

• used to treat alcohol withdrawal syndrome and anxiety

Dexmedetomidine (Precedex)

• short term sedative, light sedation , patient can be interactive, shorter time to extubation and shorter duration of delirium

• SE: hypotension and bradycardia, monitor sedation level, pulse ox, RR

Daily Sedative Interruption

A nursing practice that involves temporarily stopping sedative medications in mechanically ventilated patients to assess their readiness for extubation and reduce sedation-related complications.

• assessed using RASS/SAS

• assess neurological function

• restart sedation if agitation occurs

Haldol

• Haldol treats agitation/delirium symptoms, but it doesn’t fix the underlying cause of delirium.

• can cause QT-prolongation