sedatives Flashcards
benzodiazepine receptor agonists MOA
binds to benzodiazepine receptor; GABA agonism
zolpidem dosing
5-10 mg
many dosage forms
lower dosage for females
different benzodiazepine receptor agonists durations
eszopiclone - intermediate
zaleplon - ultra short
zolpidem - short/intermediate
benzodiazepine receptor agonists AE
complex sleep behaviors, drowsiness, somnolence
added effects w CNS depressants
do not take w high fat meal
interactions w inducers of hepatic metabolism - rifampin, CYP3A4, cimetidine
benzodiazepines MOA
bind to BZP receptors on postsynaptic GABA neuron at several sites in CNS
enhancement of the inhibitor effect of GABA
benzodiazepines precautions
not recommended for long term use not recommended in elderly tolerance and dependence may occur slow taper to prevent withdrawal do not use in pregnancy caution w other CNS depressants
BZP durations
traizolam - short for sleep onset
estazolam & tamazepam - intermediate for early morning awakenings
flurazepam & quazepam - long acting for sleep maintenance problems
benzos AEs
impaired driving, falls, rebound insomnia
triazolam - CYP3A4
ramelteon dosing
8 mg
ramelteon MOA
melatonin receptor agonist
benefits of ramelteon
not controlled substance, can be used long term
no rebound insomnia
low abuse potential
ramelteon AE
somnolence, increased prolactin
do not use w fluvoxamine (SSRI), fluconazole, rifampin, ketoconazole
indication for tasimelteon
non-24 sleep-wake disorder in the blind
doxepin MOA
histamine receptor antagonist
doxepin dosing
3-6 mg (low!!)
