Home Drug Guide Glutethimide

Drug Guide

Generic Name

Glutethimide

Brand Names Doriden

Classification

Therapeutic: Sedative, Hypnotic

Pharmacological: Central Nervous System depressant

FDA Approved Indications

  • Short-term management of insomnia

Mechanism of Action

Glutethimide depresses the central nervous system by enhancing the action of gamma-aminobutyric acid (GABA) at GABA-A receptors, leading to sedative and hypnotic effects.

Dosage and Administration

Adult: Initial dose: 300 mg at bedtime; dose may be adjusted up to 900 mg per day in divided doses.

Pediatric: Not recommended due to lack of safety data.

Geriatric: Start with lower doses due to increased sensitivity and risk of adverse effects.

Renal Impairment: Use with caution; adjust dose if necessary based on renal function.

Hepatic Impairment: Use cautiously as hepatic metabolism may be impaired.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Metabolized in the liver, primarily via hydroxylation and conjugation.

Excretion: Excreted in the urine as metabolites.

Half Life: Approximately 4-6 hours.

Contraindications

  • Hypersensitivity to glutethimide or other sedative-hypnotics.
  • History of substance abuse.

Precautions

  • Use with caution in patients with respiratory disorders, hepatic or renal impairment, or a history of addiction.
  • Monitor for development of dependence and withdrawal symptoms.

Adverse Reactions - Common

  • Drowsiness, dizziness (Common)
  • Nausea, vomiting (Less common)

Adverse Reactions - Serious

  • Respiratory depression (Rare)
  • Dependence and withdrawal symptoms (Rare)
  • Psychoses, hallucinations (Rare)

Drug-Drug Interactions

  • Other CNS depressants, including alcohol, opioids, and antihistamines (increased sedation)
  • Cimetidine or other drugs affecting hepatic metabolism (altered glutethimide levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for sedation level, respiratory status, signs of dependence, and hepatic function.

Diagnoses:

  • Risk of sedation-related falls
  • Risk for dependence

Implementation: Administer at bedtime to reduce daytime sedation; gradually taper to discontinue.

Evaluation: Assess effectiveness for insomnia and monitor for adverse effects.

Patient/Family Teaching

  • Use exactly as prescribed; do not increase dose.
  • Caution regarding drowsiness; avoid driving or operating heavy machinery.
  • Warn about potential for dependence.
  • Advise against alcohol or other CNS depressants.

Special Considerations

Black Box Warnings:

  • Potential for addiction, abuse, and overdose.
  • Use with caution, particularly with other CNS depressants.

Genetic Factors: None well established.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe sedation, respiratory depression, coma.

Treatment: Supportive care, airway management, gastric lavage if recent ingestion, activated charcoal, and symptomatic treatment. Educate about the risk of overdose especially with concurrent CNS depressants.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.