AMBIEN Zolpidem Redona Cobani Naghmeh Shahami Indication Nonbenzodiazepine

AMBIEN (Zolpidem) Redona Cobani & Naghmeh Shahami

Indication Nonbenzodiazepine hypnotic FDA-Labeled Indications: v Insomnia, Characterized by difficulty returning to sleep after middle-of-the-night awakening. v Insomnia, Short-term treatment. Non-FDA Labeled Indications: v Insomnia, Long-term treatment v Insomnia- Selective serotonin re-uptake inhibitor adverse reaction.

Mechanism of action v Binds the benzodiazepine (BZ) receptor subunit of the GABA-A receptor complex, Which is hypothesized to be responsible for sedative, anticonvulsant, anxiolytic, and myorelaxant properties. v Its relatively short half-life and its lack of active metabolites contribute to a lower incidence of daytime sleepiness. v Ambien CR, is a longer-acting form which helps to fall asleep and helps to stay asleep as well.

Adverse effects v. Common: Diarrhea, Allergic reaction, Dizziness, Headache, Somnolence, Visual disturbance, Fatigue. v. Serious: Chest pain, Tachycardia, Anaphylaxis, Hepatic encephalopathy, Complex mannerisms behavior, Depression, Suicidal thoughts, Angioedema.

contraindications v. Hypersensitivity to Zolpidem tartrate. v. Pregnancy category C v. Infant risk through breast feeding is minimal. v. Dosage are not the same in men and women. v. Not approved for use in children.

Drug interaction v. Contraindicated with: Sodium Oxybate Ciprofloxacin St. John’s Worth Telaprevir

Toxicology v. CNS depression is the primary effect and is exacerbated by co-ingestion of other sedatives. v. Ingestion of 70 to 600 mg resulted in mild toxicity and ingestion of 2 g resulted in coma.

Clinical teaching v Warn Patient of the risk of “sleep-driving” and other complex behaviors. v Counsel patient to avoid activities requiring mental alertness or coordination. v Instruct patient not to take drug with or immediately following meals. v Patient should not drink alcohol or use other CNS depressants with this drug. v Tell patient the sublingual tablet is placed under the tongue. Do not swallow whole or take with water.

Nclex question A nurse is assessing an elderly client who has been taking Zolpidem(Ambien) for three months, which of these findings would require immediate follow-up by the nurse? v v The Client’s respiratory rate is 12 per minute. The client is agitated and combative. The client has an occasional moment of forgetfulness. The client reports feeling sleepy within 10 minutes of taking the medication.

Nclex question A client prescribed Zolpidem (Ambien). Which of these outcomes should the nurse include in a plan of care? v v Normal sleep pattern will be restored. Coping behaviors will be effective in reducing anxiety. The client will not experience any panic attacks. The client reports taking the medication on a full stomach.

Nclex question The Doctor has prescribed Zolpidem (Ambien) for a client. How should it be administered? v v At time to go to bed. 30 minutes before bedtime. 45 minutes before bedtime. 1 -1. 5 hours before bed time.

Nclex question The client is taking St. John Wort. What should the nurse educate about? v v Lack of scientific evidence. May cause hot flashes. Has many drug interactions. Can reduce iron and calcium levels.

Nclex question A client is prescribed Zolpidem (Ambien). Which of the following side effects should be monitored while the client is taking this medication? v v Daytime drowsiness. Dry mouth. Sore joints. Headache.

Nclex question A nurse is teaching a client about Zolpidem (Ambien). Which is important for the nurse to include in the teaching of this drug? v v Maximum dose is 20 mg/d May lead to psychological dependence. For older adults, dose is 15 mg at bedtime. Should only be used for 21 days or less.

answers 1 - B 2 - A 3 - A 4 - C 5 - A 6 - B

references v Lilley, L. L. (2014). Pharmacology and the Nursing process. St. Louis, MI: Elsevier. v http: //www. Micromedex. com v http: //www. quizlet. com