Drugs Blog

Type of Drug:

Nonbarbiturate sedative/hypnotics. Central nervous system depressant. Short-term sleep aid.

How the Drug Works:

Nonbarbiturate sedatives and hypnotics act on the central nervous system (brain), causing drowsiness to aid in falling asleep, They are less likely to cause a slower breathing rate than barbiturate-type sedative hypnotics.

Should sleeplessness persist, a drug-free interval of 1 or more weeks should elapse before retreatment is considered. An attempt should be made to find alternative non drug therapy in chronic sleeplessness.

Uses

Chloral hydrate: To lessen anxiety and produce sleep before surgery. After surgery, chloral hydrate may be used with other medications to control pain. Also used to prevent or suppress alcohol withdrawal symptoms (suppositories).

Unlabeled Uses: Occasionally doctors may prescribe ethchlorvynol as a sedative at doses of 100 mg to 200 mg 2 or 3 times daily.

Precautions:

Dependence: Long-term use may result in dependence. Withdrawal symptoms (eg, rebound insomnia) may occur when the drug is stopped abruptly after long-term use.

Ethchlorvynol: Patients who exhibit unpredictable behavior, restlessness, or excitement in response to barbiturates or alcohol may react in this manner to ethchlorvynol. This drug should not be used for the management of insomnia in the presence of pain, unless sleep loss persists after pain is controlled with pain relievers.

Triazolam: Short-term episodes of significant memory loss have been reported with the use of triazolam. Patients, especially the elderly, may become confused or disoriented and may attempt to wander after taking the drug. Upon waking in the morning, the patient may not remember the episode.

Pregnancy: Do not use benzodiazepines during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit. Use of ethchlorvynol is not recommended during the first and second trirmesters of pregnancy. Use during the third trimester of pregnancy may produce. Symptoms in the newborn (eg, jitteriness, hyperactivity, restlessness, irrtability, disturbed sleep, hunger). There are no adequate and well controlled studies for other sedative/hypnotics in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: Benzodiazepines, chloral hydrate, zaleplon, and zolpidem appear in breast milk. It is not known if the other sedative/hypnotics appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness of estazolam, ethchlorvynol, quazepam, temazepam, triazolam, zaleplon, and zolpidem have not been established in patients younger than 18 years of age. Safety and effectiveness of flurazepam have not been established in patients younger than 15 years of age. These drugs are generally not recommended for use in children.

Elderly: Use with caution. Elderly patients may be more sensitive to these drugs. There is a risk of over sedation, “morning hangover” (grogginess in the morning), dizziness, and confusion. Smaller doses may be needed. See triazolam precaution.

Lab Tests: Lab tests may be required to monitor therapy. Tests may include blood counts, urinalysis, blood chemistry, and liver and kidney function tests.

Tartrazine: Some of these products may contain tartrazine dye (FD&C Yellow No.5), which can cause allergic reactions in certain individuals. Check package label when available or consult your doctor or pharmacist.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over the-counter or prescription medications with non barbiturate sedatives. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with non barbiturate sedatives:

• Azole antifungal agents (eg, ketoconazole)
• Cimetidine (eg, Tagamet)
• Contraceptives, oral (eg, Ortho-Novum)

Side Effects:

Every drug is capable of producing side effects. Many nonbarbiturate sedative users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Stomach pain or upset; vomiting; nausea; diarrhea; constipation; indigestion; appetite loss; gastric irritation; colitis.

Nervous System: Confusion; drowsiness; dizziness; hallucinations; headache; anxiety; depression; facial numbness; nervousness; vertigo (feeling of whirling motion); memory loss; drugged feeling; lethargy; sleeplessness; abnormal thinking; depersonalization; agitation; light­headedness; abnormal dreams; sleep disorder; euphoria (exaggerated sense of well being); incoordination; weakness; tremor.

Circulatory System: Abnormal blood counts; palpitations (pounding in the chest).

Skin: Jaundice (yellowing of skin or eyes); rash; hives; itching; abnormal skin sensations.

Other: Allergy; back pain; chest pain; fatigue; flu-like symptoms; blurred vision; mild “hangover”; aftertaste; dry mouth; urinary tract infection; conjunctivitis; migraine; arthritis; fever; double vision; abnormal vision; muscle, joint, ear, or eye pain; swelling of the arms or legs; general body discomfort; photosensitivity; sinus infection; sore throat; runny nose; bronchitis; distorted sense of smell; nosebleed; painful menstruation; abnormal acuteness of hearing; muscle tension; muscle pain; falling.

Benzodiazepines only

Digestive Tract: Heartburn; appetite loss; nausea; vomiting; diarrhea; constipation; stomach pain; indigestion; taste alterations; dry mouth.

Nervous System: Drowsiness; nervousness; talkativeness; apprehension; irritability; euphoria (exaggerated sense of well being); relaxed feeling; tremor; memory loss; tiredness; general body discomfort; dreaming or nightmares; depression; in coordination; confusion; hangover; abnormal thinking; anxiety; dizziness; disorientation; weakness; agitation; speech disorder; daytime drowsiness; feeling of whirling motion.

Circulatory System: Palpitations (pounding in the chest); chest pain.

Other: Abnormal skin sensations; joint or body pain; weakness; headache; genitourinary complaints;falling; staggering; rash; itching; leg or back pain stiffness.

Guidelines for Use:

• Dosage is individualized.
• Do not change the dose or stop taking unless advised by your doctor.
• Take immediately before going to bed.
• May cause dizziness, drowsiness, or blurred vision. Do not drive or per­form other tasks requiring alertness, coordination, or physical dexterity.
• Avoid alcohol and other drugs that cause drowsiness (eg, pain relievers, sedatives).
• Contact your doctor if you notice any unusual or disturbing thoughts or behaviors during treatment with any sleep medicine.
• Do not take any sleep medicine unless you are able to get a full night of sleep before you must be active again.
• May cause photosensitivity (sensitivity to light). Avoid prolonged expo­sure to the sun. Use sunscreens and wear protective clothing until tolerance is determined.
• May be habit forming. Do not discontinue drug abruptly after prolonged use, especially if you have a history of seizures, regardless of other anti seizure medications you may be taking.
• Contact your doctor if visual changes, irregular heartbeats, chest pains, yellowing of skin or eyes, rash, or unusual bleeding or bruising occurs.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Benzodiazepines - Nighttime sleep may be disturbed for 1 or 2 nights following stopping of the drug. Tell your doctor if you are pregnant, plan to become pregnant, or become pregnant while taking this medicine.
• Chloral hydrate May cause stomach upset. Take capsules with a full glass of water or other liquid. Swallow capsules whole. Do not crush or chew. Dilute syrup in a half glass of water, ginger ale, or fruit juice.
• Ethchlorvynol- Symptoms of giddiness, incoordination, and stomach upset may be reduced if medication is taken with food.
• Triazolam - Do not take when a full night’s sleep and elimination of the drug from the body are not possible before the need to be active and functional. May cause amnesia.
• Zaleplon - Do not take with or immediately following a high fat or heavy meal. May cause sleepiness during the day. Daytime drowsiness can be best avoided by taking the lowest possible dose. May cause amnesia. In most cases, memory problems can be avoided if zaleplon is taken only when you are able to get 4 hours or more of sleep before being active.
• Zolpidem - For faster sleep onset, do not take with or immediately after a meal.

Tagged under:blood, Central Nervous System Agents, circulatry system, hypnotics, hypnotics information nonbarbiturate