Home Drug Guide Zaleplon

Drug Guide

Generic Name

Zaleplon

Brand Names Sonata

Classification

Therapeutic: Sedative/Hypnotic for Insomnia

Pharmacological: GABA-A Receptor Agonist, Non-benzodiazepine

FDA Approved Indications

  • Short-term treatment of insomnia, primarily for sleep onset difficulties

Mechanism of Action

Zaleplon binds selectively to GABA-A receptor complexes containing the alpha-1 subunit, enhancing GABA-mediated chloride ion influx, leading to sedative effects and facilitating sleep onset.

Dosage and Administration

Adult: 10 mg taken immediately before bedtime; may be adjusted to 5 mg or 20 mg based on response and tolerability.

Pediatric: Not indicated for pediatric use.

Geriatric: Initially 5 mg due to increased sensitivity; dose adjustment may be necessary.

Renal Impairment: Use with caution; consider dose reduction.

Hepatic Impairment: Use with caution; typically start with 5 mg.

Pharmacokinetics

Absorption: Rapidly absorbed, peak plasma levels in approximately 1 hour.

Distribution: Widely distributed; volume of distribution approx. 0.5-0.8 L/kg.

Metabolism: Extensively metabolized in the liver primarily via aldehyde oxidase and CYP3A4.

Excretion: Metabolites excreted mainly in urine; parent compound minimally excreted.

Half Life: Approximately 1 hour, supporting its rapid onset and short duration of action.

Contraindications

  • Hypersensitivity to zaleplon or any component

Precautions

  • History of drug abuse or dependency, hepatic impairment, depression, or suicidal ideation.
  • Use caution in patients with a history of complex sleep behaviors such as sleepwalking or sleep-driving.

Adverse Reactions - Common

  • Headache (Common)
  • Dizziness (Common)
  • Nausea (Common)
  • Somnolence (Common)

Adverse Reactions - Serious

  • Complex sleep behaviors (e.g., sleepwalking, sleep-driving) (Rare)
  • Angioedema, hypersensitivity reactions (Rare)
  • Respiratory depression (Rare)

Drug-Drug Interactions

  • CNS depressants (additive sedative effects)
  • OATP inhibitors (may increase zaleplon levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of excessive sedation, sleep behaviors, or adverse reactions.

Diagnoses:

  • Risk for injury due to impaired cognition or sleep behaviors.
  • Risk for overdose.

Implementation: Administer immediately before bedtime. Avoid alcohol and other CNS depressants. Monitor hepatic function in long-term use.

Evaluation: Assess sleep quality, side effects, and adverse reactions.

Patient/Family Teaching

  • Take drug exactly as prescribed, immediately before bed.
  • Avoid alcohol and CNS depressants.
  • Report any sleep behaviors such as sleepwalking.
  • Avoid driving or operating machinery until alertness is confirmed.

Special Considerations

Black Box Warnings:

  • Complex sleep behaviors (e.g., sleepwalking, sleep-driving, sleep-eating) may occur and have led to injuries.
  • Use with caution in the elderly due to increased risk of falls.

Genetic Factors: Variability in CYP3A4 activity may affect drug levels.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Excessive sedation, respiratory depression, coma.

Treatment: Supportive care, airway management, possible use of flumazenil in specific cases (off-label), monitor vital signs, and provide respiratory support as needed.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable for shelf life as indicated on packaging.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.