The article describes the development, implementation, and success of guidelines for pharmacological management of sedation and agitation in critically ill patients in a community hospital. Guidelines were developed with careful review of published literature and in cooperation with thought leaders in the institution. The primary focus of the guidelines was choice of medication and monitoring parameters and an educational campaign to ensure use of the guidelines. A prospective pharmacist intervention program was initiated for further enforcement of the guidelines. Implementation of these guidelines has resulted in a significant reduction in the cost of sedation and agitation (annual cost savings, >$40,000 per year).