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Questions and Answers
What is the drug class of Z drugs?
What are the indications for Z drugs?
Short-term treatment of debilitating or distressing insomnia.
What is the mechanism of action (MOA) of Z drugs?
They target the GABA type A receptor, facilitating GABA's binding.
Which of the following are common adverse effects of Z drugs?
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Z drugs should be prescribed without caution in elderly patients.
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What should be avoided when taking Z drugs?
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How should Z drugs be prescribed?
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How are Z drugs administered?
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What should be discussed with patients during counselling regarding Z drugs?
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What should be monitored when a patient is prescribed Z drugs?
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Study Notes
Drug Class
- Zopiclone is classified as a Z drug, which are non-benzodiazepine hypnotics and sedatives.
Indications
- Primarily used for the short-term treatment of debilitating or distressing insomnia, although non-pharmacological treatments are preferred.
Mechanism of Action (MOA)
- Z drugs act on the GABA type A receptor, similar to benzodiazepines.
- They facilitate GABA binding, enhancing inhibitory effects in the brain, leading to reduced anxiety, sleeplessness, and sedation.
- Not effective as anticonvulsants and have a shorter duration of action compared to most benzodiazepines.
Adverse Effects
- Common effects include daytime sleepiness, which can impair driving and complex tasks.
- Possible rebound insomnia after cessation of use.
- Other neurological issues include headaches, confusion, nightmares, and rarely amnesia.
- Unique adverse effects: Zopiclone may cause taste disturbance; Zolpidem is more likely to cause gastrointestinal upset.
- Prolonged use beyond four weeks can lead to dependence and withdrawal symptoms such as headaches and anxiety.
- Overdose can cause severe drowsiness, coma, and respiratory depression.
Warnings
- Use with caution in the elderly due to increased sensitivity to neurological effects.
- Contraindicated in patients with obstructive sleep apnoea or respiratory depression as it may exacerbate conditions.
Interactions
- Z drugs can amplify the sedative effects of alcohol, antihistamines, and benzodiazepines.
- Enhance hypotensive effects of antihypertensive medications.
- Metabolism through CYP450 enzymes: Inhibitors (e.g., macrolides) increase sedation, while inducers (e.g., phenytoin, rifampicin) may reduce sedation.
Prescription Guidelines
- Prescribed at the lowest effective dose for the shortest duration, typically no longer than two weeks.
- Common doses include Zopiclone 7.5 mg or Zolpidem 10 mg taken at bedtime.
- Starting doses for elderly patients should be halved.
Administration
- Available for oral use only, in the form of tablets or capsules.
Patient Counselling
- Emphasize that sleeping tablets are a short-term solution for insomnia.
- Discuss underlying reasons for insomnia and provide sleep hygiene advice.
- Advise against regular use due to potential dependency; maximum usage should be 2-4 weeks.
- Warn about the risk of drowsiness affecting driving or operating heavy machinery the following day.
Monitoring
- Clinical monitoring for efficacy and safety is essential during treatment.
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Description
Test your knowledge on Zopiclone and its classification as a non-benzodiazepine hypnotic. Explore its indications, mechanism of action, and more through these flashcards. Perfect for students and professionals in pharmacology or medicine.
