In so m n ia a n d An xie ty Meds
1. Anxiolytics, Sleep Medications-page 366 in the review and resource
manual, see supplemental learning materials in course tips.
2. Benzodiazepines: indications, short term use, risk of tolerance and
dependence, contraindications (ex: PTSD or delirium).
3. Hypnotics/sleep medications: short acting, intermediate acting and
long-acting medications. Page 365-366 in review and resource
manual. Benzodiazepines and Nonbenzodiazepines. Flurazepam,
Temazepam, Triazolam, Sonata, Lunesta, Ambien, Rozerem,
Belsomra,
Elavil, doxepin, Remeron, Trazodone
a. Z-Drugs: Zaleplon, zolpidem, zopiclone. Allosteric Modulators of
GABA-A.
i. Zaleplon (Sonata)
1. FDA for Insomnia. Short Term. Sleep Onset.
2. Avoid with high fat meals.
3. D, Somnolence, H/e
4. Selective GABA alpha 1 subunit agonist.
5. Take immediately before bed. Rarely causes next
day impairment.
6. Most useful for sleep initiation disorders.
ii. Zolpidem(Ambien)
1. Insomnia. Short term sleep onset.
2. S/E H/e, somnolence, dizzy, diarrhea.
3. Sleep driving, sleep cooking, sleep eating.
4. Selective GABA alpha 1 subunit agonist.
5. Less withdrawal affects. CR can help gradually fall
to sleep.
iii. Eszopiclone(Lunesta):
1. Bad metallic taste
2. Insomnia. Sleep onset AND maintenance
3. S/E: Somnolence, h/e, unpleasant taste, dizzy,
dry mouth.
4. Large high fat meal delays by an hour. Taken
immediately before bed.
5. Higher doses increase next day impairment.
b. Benzo(also zopiclone/eszopiclone) bind to A1, A2, A3, and
, A5. A1 is critical for producing sedation.
1. Anxiolytics, Sleep Medications-page 366 in the review and resource
manual, see supplemental learning materials in course tips.
2. Benzodiazepines: indications, short term use, risk of tolerance and
dependence, contraindications (ex: PTSD or delirium).
3. Hypnotics/sleep medications: short acting, intermediate acting and
long-acting medications. Page 365-366 in review and resource
manual. Benzodiazepines and Nonbenzodiazepines. Flurazepam,
Temazepam, Triazolam, Sonata, Lunesta, Ambien, Rozerem,
Belsomra,
Elavil, doxepin, Remeron, Trazodone
a. Z-Drugs: Zaleplon, zolpidem, zopiclone. Allosteric Modulators of
GABA-A.
i. Zaleplon (Sonata)
1. FDA for Insomnia. Short Term. Sleep Onset.
2. Avoid with high fat meals.
3. D, Somnolence, H/e
4. Selective GABA alpha 1 subunit agonist.
5. Take immediately before bed. Rarely causes next
day impairment.
6. Most useful for sleep initiation disorders.
ii. Zolpidem(Ambien)
1. Insomnia. Short term sleep onset.
2. S/E H/e, somnolence, dizzy, diarrhea.
3. Sleep driving, sleep cooking, sleep eating.
4. Selective GABA alpha 1 subunit agonist.
5. Less withdrawal affects. CR can help gradually fall
to sleep.
iii. Eszopiclone(Lunesta):
1. Bad metallic taste
2. Insomnia. Sleep onset AND maintenance
3. S/E: Somnolence, h/e, unpleasant taste, dizzy,
dry mouth.
4. Large high fat meal delays by an hour. Taken
immediately before bed.
5. Higher doses increase next day impairment.
b. Benzo(also zopiclone/eszopiclone) bind to A1, A2, A3, and
, A5. A1 is critical for producing sedation.
