Meds to given instead of ambien?

Nurses General Nursing

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I gave a patient ambien because the pt. requested something to help her sleep. This is in an ICU recently extubated (day shift). Currently on 2L NC. Pretty much at this point just making sure she remains stable then transfering her to another unit. But anyway I gave her ambien thinking it would help her sleep and it did for about 30 min until she woke up and started trying to take her gown of and "re-dress herself." Though she was technically oriented x3 she could tell me where she was, who she was and situation. She thought she had a dress on and thought she had to call the person who mows her lawn. What medication would have been more appropirate? Any suggestions?

Specializes in Medical ICU.

Most of the time the physician will give trazadone (25mg or 50mg) , unless the patient has been prescribed ambien by their regular doctor. I find that if a patient takes Ambien for the first time in the ICU, most of the time they will have negative side effects similar to those you mentioned.

Specializes in ER.

I hate giving Ambien to my patients for that very reason. There's been quite a few times where it'll make my patient go coo-coo for coco puffs. If they've got it on their MAR, I make sure if they've had it before or take it at home.

I prefer Restoril 15mg. I think it doesn't affect my patients as badly as Ambien, but my coworkers have told me otherwise.

We use a lot of ambien and have had similar experiences as well. It's the one most docs have a standing order for so unless the patient takes something else at home that's what the majority of patients are going to get. I prefer benadryl personally. It doesn't work for everyone, but unless people take something at home to help them sleep it's usually enough. We give restoril and trazadone as well, but trazadone is almost never ordered for our patients unless it's one they take at home.

Specializes in LTC.

I see a lot of trazadone, benedryl (tyl pm), and melatonin.

Lunesta, Ativan, or a Xanax I've also seen

Those hypnotic effects are one of the reasons I dislike Ambien and am reluctant to give it to patients unless they are regular users. The docs don't like it either and rarely prescribe it. Trazadone, Restoril, Elavil or even Valium are better choices for short-term sleep aids.

Specializes in Trauma Surgery, Nursing Management.

Ambien can be very scary. I took this myself once and my husband told me the next morning that he was awakened by me lighting candles in the living room. I have no recollection AT ALL of doing that.

I see a lot of Benadryl and Lunesta. I haven't seen melatonin prescribed in the hospital but would love to see that.

Just out of curiosity, does ibuprofen make anyone sleepy? I can't take it during the working shift because I want to take a nap. Anyone else have this experience?

Specializes in PACU, OR.
Ambien can be very scary. I took this myself once and my husband told me the next morning that he was awakened by me lighting candles in the living room. I have no recollection AT ALL of doing that.

I see a lot of Benadryl and Lunesta. I haven't seen melatonin prescribed in the hospital but would love to see that.

Just out of curiosity, does ibuprofen make anyone sleepy? I can't take it during the working shift because I want to take a nap. Anyone else have this experience?

Not ibuprofen, no, but it's weird that if I've had a shot of diclofenac 75mg IMI I always have to lie down and sleep afterwards. I have absolutely no clue why that happens....

Even if Ambien is a home med, the patient may go nutty. They may say they do fine taking it at home but they will have no clue that they are doing crazy or dangerous things "in their sleep". I ALWAYS ask for an alternate sleep aid. I despise Ambien. I prefer Xanax over Ativan in the elderly because Ativan tends to hype the elderly up, too. Younger patients do best on Xanax or Benadryl, in my experience.

Specializes in Psych ICU, addictions.

As alternatives to Ambien and Lunesta, we use Trazodone a lot...Restoril, Benadryl and Doxepin are also popular choices.

Specializes in Critical Care.

I try to never give Ambien for the same reasons the OP mentioned. I like benedryl. It does some good most of the time. I've seen docs order different things and it sometimes is specific to what service is covering the patient. Our trauma service seems to like trazadone, seroquel, and restoril. Others may like just some ativan or xanax. I'd be happier giving them some benedryl and if needed a little ativan or opiates.

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