Nonbenzodiazepines-nonbarbiturates
Nonbenzodiazepine-nonbarbiturates
act
as hypnotics for treatment of simple insomnia. These drugs, which offer
no special advantages over
other sedatives, include:
• chloral hydrate
• eszopiclone
• ramelton
• zaleplon
• zolpidem.
Chloral hydrate and zaleplon
lose their effectiveness by the end of the second week. Zolpidem is
usually effective for up to 35 days.Eszopiclone and ramelton are approved for long-term
treatment of insomnia.
Nonbenzodiazepines-nonbarbiturates are absorbed
rapidly from the GI tract, metabolized in the liver, and excreted in urine.
The mechanism of action for
nonbenzodiazepines-nonbarbiturates isn’t fully known; however, they produce
depressant effects simi-lar to barbiturates.
Nonbenzodiazepines-nonbarbiturates are typically
used for:
·
treatment of simple insomnia
·
sedation before surgery
·
sedation before EEG studies.
When nonbenzodiazepines-nonbarbiturates are used
with other CNS depressants, additive CNS depression occurs, resulting in
drowsiness, respiratory depression, stupor, coma, or death. (See Warning about sleep agents.)
Chloral hydrate may increase the risk of bleeding
in patients tak-ing oral anticoagulants. Use with I.V. furosemide may produce sweating,
flushing, variable blood pressure, and uneasiness. (See Adverse reactions to nonbenzodiazepines-nonbarbiturates.)
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