Nonbenzo Hypnotics

Question 1

Names

Answer 1

Zaleplon (1 hours)
Zolpidem (3 hours)
Eszopiclone (5-7 hours)
Melatonin (1-2 hours)
Ramelteon (1-2 hours)
Chloral hydrate- trichloroethanol

Question 2

Method of Action

Answer 2

Binding allosterically at GABAa facilitating Cl- transport at same portion as benzos
Less anxiolytic and anticonvulsant activity
Rapid onset and short duration

Question 3

Pharmacokinetics

Answer 3

Rapidly metabolised in liver

Don’t co-administer with other sedatives

Question 4

Use

Answer 4

Falling asleep- zolpidem and zaleplon- short T1/2

Falling and staying asleep- eszopiclone

Question 5

Side Effects

Answer 5

Elderly are sensitive
Sedation
Delirium
Trunk ataxia
No tolerance development less dependence

Question 6

Flumazenil

Answer 6

Antidote- competitive antagonist
T1/2: 0.7-3 hours
Agitation and confusion
Controversial in overdose due to withdrawal seizures

Question 7

Melatonin agonists

Answer 7

Agonists at MT1 and MT2 in SCN in Hypothalamus
Safer in the elderly
Doesn’t affect sleep architecture, rebound insomnia, or withdrawal