Drugs Used to Treat Sleep Disorders (Insomnia) Flashcards
Benzodiazepines should only be taken how often if used as a sleeping aid?
Short-term basis, between 1-3 months
No more than 3 times per week
Which benzodiazepines should be prescribed for the elderly? Why?
LOT
Lorazepam, Oxazepam, Temazepam
They only go through phase II metabolism, so there are no active metabolites
List the non-benzodiazepine medications approved for sleep disorders. What are the side effects?
Imidazopyridines: Zolpidem, Zaleplon
Pyrrolopyrazines: Ezoplicone
ZZZ for more ZZZ”s
Side effects: sleep walking, sleep driving, sleep eating..
Name the melatonin receptor agonist that may be used as a sleep aid. Why is not commonly prescribed?
Ramelteon
Problem: cost
What is the active ingredient in valerian used in the treatment of insomnia?
Sesquiterpene
How does sesquiteripine work to induce sedation?
mediates GABA release and inhibits GABA breakdown
What is the active ingredient in camomile for the induction of sedation?
apigenin
How does apigenin cause sedation?
benzodiazepine agonist
What is the active compound in passion flower?
Chrysin
How does chrysin cause sedation?
benzodiazepine partial agonist
What are the two OTC sleep aids available? How doe they work?
Doxylamine and diphenhydramine- both are antihistamines
What is the site of action of buspirone?
5HT-1 A partial agonist – fairly unique
What is the DDI risk with buspirone?
do not use with MAO-I’s : must wash out first (at risk for serotonin syndrome)
What are the three clinical uses of buspirone?
1) GAD
2) with antidepressants for major depression
3) with antidepressants for anxiety disorder
What is the biggest disadvantage of buspirone as compared to benzodiazepines and other antidepressants/
Less effective
