Sleep- Z-drugs DI

Question 1

Z-drugs used in insomnia treatment

Answer 1

Eszopiclone, zaleplon, zolpidem

Question 2

Eszopiclone brand name

Answer 2

Lunesta

Question 3

Zaleplon brand name

Answer 3

Sonata

Question 4

Zolpidem brand name

Answer 4

Ambien

Question 5

Eszopiclone indication

Answer 5

Sleep onset and maintenance

Can be used long-term up to 6 months

Question 6

Zaleplon indication

Answer 6

Sleep onset

Used short-term, up to 30 days

Question 7

Zolpidem indication

Answer 7

Depends on the formulation:

IR tablet and spray: sleep ONSET

ER tablet: sleep onset AND maintenance

Question 8

What’s unique about zolpidem dosing?

Answer 8

Males can get double the dose that females get

Question 9

Eszopiclone ADEs

Answer 9

HA, dysgeusia, nervousness/anxiety, xerostomia, infection, stomach upset

Question 10

Zaleplon ADEs

Answer 10

HA, nausea, abdominal pain

Question 11

Zolpidem ADEs

Answer 11

HA, nausea

Question 12

Z-drug BBW

Answer 12

Complex sleep behaviors- D/C if it’s experienced!

Question 13

Eszopiclone DDI

Answer 13

major 3A4 substrate → monitor with ketoconazole, itraconazole, etc. and reduce dose to 1mg

Question 14

Zaleplon DDI

Answer 14

major 3A4 substrate → interacts with 3A4 inducers like cimetidine, rifampin, etc.

Question 15

Avoid zolpidem in what disease state?

Answer 15

Severe hepatic impairment

Question 16

Z-drugs are what Schedule CS?

Answer 16

CIV

Question 17

Taking eszopiclone and zaleplon with food does what?

Answer 17

Delay the onset/absorption

Question 18

Zaleplon is excreted in breastmilk- true or false?

Answer 18

True

Question 19

Zaleplon half-life

Answer 19

1 hour- it’s good for sleep onset!

Question 20

What formulation of zolpidem is a first-line option in sleep onset and sleep maintenance insomnia? (from the guidelines/chart)

Answer 20

Zolpidem IR

Question 21

Duration of effect of eszopiclone

Answer 21

6-9 hours

Question 22

Duration of effect of zaleplon

Answer 22

3-4 hours