ZOLPIDEM

INTRODUCTION:  Favorable clinical features of zolpidem and the other newer hypnotics include rapid onset of activity and modest day-after psychomotor depression with few amnestic effects.  Zolpidem, one of the most frequently prescribed hypnotic drugs, is available in a biphasic release formulation that provides sustained drug levels for sleep maintenance.

ACTIONS AND USES:  Although it is a nonbenzodiazepine, zolpidem acts in a similar fashion to facilitate GABA-mediated CNS depression in the limbic, thalamic, and hypothalamic regions. It preserves stages III and IV of sleep and has only minor effects on REM sleep. The only indication for zolpidem is for short-term insomnia management (7 to 10 days).

ADMINISTRATION ALERTS:  Because of rapid onset, 7–27 minutes, give immediately before bedtime, care must be taken not to operate anything after taking the drug.

Pregnancy category B.

ADVERSE EFFECTS:  Adverse effects include daytime sedation, confusion, amnesia, dizziness, depression, nausea, and vomiting. 

Contraindications: Lactating women should not take this drug. 

INTERACTIONS:  Drug–Drug: Drug interactions with zolpidem include an increase in sedation when used concurrently with other CNS depressants, including alcohol. Phenothiazines augment CNS depression.  

Treatment of Overdose: Generalized symptomatic and supportive measures should be applied with immediate gastric lavage where appropriate. IV fluids should be administered as needed. Use of flumazenil as a benzodiazepine receptor antagonist may be helpful. 

RELATED;

1.  DRUGS USED IN INDUCTION OF SLEEP  2.