CNS exam 3 top drugs

ramelteon dose

Rozarem

ramelteon class

sedative/hypnotic

Ramelteon MOA

potent sedative agonist of MT1 and MT2 melatonin receptor in superchiasmic nucleus of hypothalamus

ramelteon dose

8 mg 30 minutes before bed

ramelteon contra

avoid alcohol

ramelteon BBW

none

eszopiclone brand

lunesta

eszopiclone class

non-benzo hypnotic

eszopiclone MOA

interacts with GABA receptor complexes coupled to binding domain close to benzo receptor

eszopiclone dose

1-3 mg HS

eszopiclone contra

history of drug dependence

eszopiclone BBW

none

hydroxyzine brand

Atarax, Vistaril

hydroxyzine class

H1 antihistamine

hydroxyzine use

anxiety, pruritis/urticaria, nausea/vomiting

hydroxyzine MOA

non-selectively antagonizes central and peripheral H1 histamine receptors

hydroxyzine dose

25-100 mg Q4-6hr prn

hydroxyzine contra

QT prolongation, hypersensitivity to cetirizine or levocetirizine

hydroxyzine BBW

none

diazepam brand

valium, diastat

diazepam class

long acting BZD

diazepam use

seizure disorder, anxiety sedation

diazepam MOA

bind to BZD receptor, enhance GABA effects

diazepam dose

2-10 mg PO BID/QID

5-10 mg IM/IV q3-4 hrs

diazepam contra

avoid abrupt withdrawal

diazepam BBW

use with opioids may result in respiratory depression, sedation, coma, death

zolpidem brand

Ambien

zolpidem class

insomnia anxiolytic/hypnotic

zolpidem use

insomnia short term

zolpidem MOA

interacts with GABA-BZD receptor complexes

zolpidem dose

5-10 mg qHS IR

6.25-12.5 mg PO QHS ER

zolpidem contra

alcohol use, hepatic impairment, Hx of complex sleep behavior

zolpidem BBW

complex sleep behavior, sleep walking, driving etc

lorazepam brand

ativan

lorazepam class

intermediate acting BZD

lorazepam use

anxiety insomnia, status epilepticus

lorazepam MOA

bind to BZD receptors, enhancing GABA effects

lorazepam dose

2-6 mg BID-TID

lorazepam contra

renal failure, respiratory impairment, sleep apnea, avoid abrupt withdrawal

lorazepam BBW

use with opioids may result in respiratory depression, profound sedation, coma, death

clonazepam brand

klonopin

clonazepam class

long acting BZD

clonazepam use

seizure disorder, panic disorder

clonazepam MOA

bind to BZD receptor, enhance GABA effects

clonazepam dose

0.5-5 mg TID

clonazepam contra

hepatic impairment avoid abrupt withdrawal

clonazepam BBW

use with opioids may cause respiratory depression, profound sedation, coma, death

alprazolam brand

xanax, niravam

alprazolam class

short acting BZD

alprazolam approved use

anxiety, panic disorder

alprazolam MOA

bind to BZD receptor, enhance GABA effects

alprazolam dose

0.5-3 mg TID

ER 3-6 mg QD

alprazolam contra

avoid abrupt withdrawal

alprazolam BBW

use with opioids may cause respiratory depression, profound sedation, coma, death

trazodone brand

oleptro

trazodone class

serotonin modulator

trazodone use

MDD insomnia

trazodone MOA

antagonize 5HT2A/C and alpha-1 adrenergic receptors, inhibit serotonin reuptake

trazodone dose

50-100 mg BID-TID

trazodone contra

avoid abrupt withdrawal

trazodone BBW

may cause suicidal thoughts in children and young adults

temazepam brand

restoril

temazepam class

intermediate acting BZD

temazepam use

insomnia

temazepam MOA

bind to BZD receptors, enhance GABA effects

temazepam dose

7.5-30 mg qhs prn

temazepam contra

avoid abrupt withdrawal

temazepam BBW

use with opioid may cause profound sedation, respiratory depression, coma, death