cns 2 exam 3 top 300 drugs

ramelteon

rozerem

ramelteon class

sedative/hypnotic, melatonin receptor agonist

ramelteon dose

8 mg PO within 30 minutes of bedtime

ramelteon contraindications

abnormal behavioral changes, hazardous sleep-related activities such as sleep driving, cooking, and eating food; avoid alcohol

eszopiclone brand

lunesta

eszopiclone class

hypnotic, non-benzodiazepine

eszopiclone dose

1-3 mg PO QHS (max 3 mg)

eszopiclone contraindications

use with caution in pts with a history of drug dependence; hypnotics/sedatives have been associated with abnormal thinking and behavior changes including decreased inhibition, aggression, bizarre behavior, agitation, hallucinations, and depersonalization

lorazepam

ativan

lorazepam class

benzodiazepine, intermediate-acting

lorazepam uses

anxiety, insomnia, status epilepticus

lorazepam MOA

binds to benzodiazepine receptors; enhances GABA effects

lorazepam dose

2-6 mg/day PO/IM/IV divided BID-TID

lorazepam contraindications

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

lorazepam BBW

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

clonazepam

klonopin

clonazepam class

benzodiazepine, long-acting

clonazepam uses

seizure disorders, panic disorder

clonazepam MOA

binds to benzodiazepine receptors; enhances GABA effects

clonazepam dose

0.5-5 mg PO TID

clonazepam contraindications

hepatic impairment, avoid abrupt withdrawal

clonazepam BBW

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

alprazolam

xanax, niravam ODT

alprazolam class

benzodiazepine, short acting

alprazolam uses

anxiety, panic disorder

alprazolam MOA

binds to benzodiazepine receptors; enhances GABA effects

alprazolam dose

0.5-3 mg PO TID ER: 3-6 mg PO QD

alprazolam contraindications

avoid abrupt withdrawal

alprazolam BBW

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

trazodone brand

oleptro

trazodone class

serotonin modulators

trazodone uses

major depressive disorder, insomnia

trazodone MOA

antagonizes serotonin 5HT2A/C and alpha-1 adrenergic receptors, inhibits serotonin reuptake

trazodone dose

50-100 mg PO BID-TID

trazodone contraindications

avoid abrupt withdrawal

trazodone BBW

may cause suicidal thoughts in children and young adults

temazepam brand

restoril

temazepam class

benzodiazepine, intermediate acting

temazepam uses

insomnia

temazepam MOA

binds to benzodiazepine receptors; enhances GABA effects

temazepam dose

7.5-30 mg PO QHS

temazepam contraindications

avoid abrupt withdrawal

temazepam BBW

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

diazepam brand

valium, diastat

diazepam class

benzodiazepine, long acting

diazepam uses

seizure disorders, anxiety, sedation

diazepam MOA

binds to benzodiazepine receptors; enhances GABA effects

diazepam dose

2-10 mg BID-QID or 5-10 IM/IV q3-4h

diazepam contraindications

avoid abrupt withdrawal

diazepam BBW

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

hydroxyzine brand

atarax, vistaril

hydroxyzine class

antihistamine (H1)

hydroxyzine uses

anxiety, pruritis/urticaria, nausea/vomiting

hydroxyzine MOA

non-selectively antagonizes central and peripheral histamine H1 receptors

hydroxyzine dose

25-100 mg PO/IM q4-6 hours prn

hydroxyzine contraindications

QT prolongation, hypersensitivity to cetirizine or levocetirizine

hydroxyzine BBW

none

zolpidem brand

ambien

zolpidem class

insomnia (anxiolytic, hypnotic)

zolpidem uses

insomnia, short term

zolpidem MOA

interacts with GABA-benzodiazepine receptor complexes

zolpidem dose

IR: 5-10 mg PO QHS ER: 6.25-12.5 mg PO QHS

zolpidem contraindications

alcohol use, hepatic impairment, history of complex sleep behavior

zolpidem BBW

complex sleep behaviors may occur. sleep walking, sleep driving, other activities