Prototype Drug Unit 1 & 2 Exam- Zopidem (Ambien, Edluar, others) Flashcards
What is the Therapeutic classification of Zolpidem?
Sedative-hypnotic
What is the pharmacologic classification of Zolpidem?
Nonbenzodiazepine anxiolytic, miscellaneous CNS depressant
What are the therapeutic uses and effects of Zolpidem?
Used for short-term treatment of insomnia. Decreases sleep-onset time and the number of nighttime awakenings and improves the length and quality of sleep. Should be administered before expected sleep due to its rapid onset of action. It has a lack of active metabolites and a short half-life reduce the incidences of excessive daytime drowsiness and rebound insomnia.
What is the mechanism of action for Zolpidem?
They enhance the action of GABA, the inhibitory neurotransmitter, but they only bind to one specific type of GABA receptor (omega-1).
What is the route of Zolpidem?
PO
What is the absorption of Zolpidem?
70% absorbed
Widely distributed; unknown if it crosses the placenta; small amounts are secreted in breast milk; 92% bound to plasma protein
Where is it primarily metabolized?
The Liver (hepatically)
How is it primarily excreted
Renal, small amounts in bile and feces
What are the adverse effects of Zolpidem?
Dizziness, diarrhea, and daytime drowsiness. It is a schedule 4 that can lead to abuse and lead to dependency.
What are the contraindications/precautions of Zolpidem?
Do not give to people with a hypersensitivity of Zolpidem. Give cautiously when there are other CNS depressants being taken. Dosage should be lowered when given to people who have impaired kidneys or livers. Use with caution for people who are suicidal.
What are the drug interactions of Zolpidem?
Cna interact with drugs that induce or inhibit the enzyme system of CYP3A4. When used with CNS depressants, including alcohol, will cause additive sedation. When used with SSRI’s, disorientation or worsening of depresison may occur.
What are the herbal/food interactions?
Should be taken on an empty stomach because food reduces absorption. St. John’s wort may cause confusion and alluncinations. Valerian, kava, and melatonin supplements may cause additive sedation.
What is the pregnancy category of Zolpidem?
Category B (immediate release) or C (extended release)
What is the treatment of overdose for Zolpidem?
The benzodiazepine antagonist flumazenil will reverse the sedative effects of zolpidem but may precipitate seizures. Other treatment involves supportive care, such as gastric lavage.
What are the nursing responsibilites of Zolpidem?
1) Assess (get a full history. Check for disturbances in thought processes, preception, verbal communication, affect behavior, interpersonal relationships, and self-care. Get vital signs. Evaluate lab findings. Assess the patient’s ability to receive and understand instructions.)
2) Give Medications
3) Reassess (Check to see if therapeutic effects are working. Continue to monitor vital signs. Monitor motor activity and coordination. Ensure adequate nutrition. Monitor for and immediately report signs and symptoms of NMS: unstable blood pressure, elevated temp, diaphoresis, muscle regidity. Monitor cardiovascular and respiratory function for frequently with elderly people with dementia. Monitor for the possibility of pregnancy in women of childbearing age. Monitor for alcohol and illegal drug use. Monitor caffeine use. Monitor for smoking.)
4) Help patient understand drug therapy, desired therapeutic outcomes, commonly adverse effects, parameters for when to call the health care provider, and any necessary monitoring or precautions.
5) Help Patient understand how to self-administer the drug
