Home Drug Guide Zolpidem Tartrate

Drug Guide

Generic Name

Zolpidem Tartrate

Brand Names Ambien, Tovalt Odt, Ambien Cr, Edluar, Zolpimist, Intermezzo

Classification

Therapeutic: Sedative-Hypnotic for Insomnia

Pharmacological: Imidazopyridine receptor agonist

FDA Approved Indications

  • Short-term treatment of insomnia characterized by difficulty with sleep initiation

Mechanism of Action

Zolpidem binds selectively to the alpha-1 subunit of the GABA-A receptor complex, enhancing GABAergic inhibition and leading to sedative effects.

Dosage and Administration

Adult: 5-10 mg at bedtime, with adjustments based on response and tolerability

Pediatric: Not approved for pediatric use

Geriatric: Start with lower doses, typically 5 mg, due to increased sensitivity

Renal Impairment: Use lower dose; monitor closely

Hepatic Impairment: Start with 5 mg; avoid in severe impairment

Pharmacokinetics

Absorption: Rapid absorption, peak plasma levels in about 2 hours

Distribution: Widely distributed, crosses the blood-brain barrier

Metabolism: Primarily hepatic via CYP3A4 enzyme

Excretion: Metabolites excreted in urine

Half Life: 2-3 hours in healthy adults, may be extended in elderly

Contraindications

  • Hypersensitivity to zolpidem or any component of the formulation
  • History of complex sleep behaviors (e.g., sleepwalking, sleep driving)

Precautions

  • Use with caution in patients with a history of substance abuse, hepatic impairment, or respiratory impairment; avoid alcohol and CNS depressants during therapy

Adverse Reactions - Common

  • Dizziness (Common)
  • Drowsiness (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Complex sleep behaviors (e.g., sleepwalking, sleep-driving) (Serious but rare)
  • Anaphylaxis or angioedema (Rare)
  • Bitter taste, nausea, or allergic reactions (Rare)

Drug-Drug Interactions

  • CNS depressants, including alcohol, antidepressants, other sedatives/hypnotics, opioids

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess sleep patterns, sleep quality, and adverse effects

Diagnoses:

  • Risk for injury due to somnolence or complex sleep behaviors

Implementation: Administer immediately before bedtime; monitor for adverse effects

Evaluation: Evaluate sleep quality, adverse effects, and safety parameters regularly

Patient/Family Teaching

  • Take medication exactly as prescribed. Do not increase dose or frequency.
  • Avoid alcohol and other CNS depressants.
  • Be cautious of activities requiring full alertness (e.g., driving) after waking.
  • Report any complex sleep behaviors or unusual reactions.

Special Considerations

Black Box Warnings:

  • Complex sleep behaviors (e.g., sleepwalking, sleep eating, sleep driving)

Genetic Factors: None specified

Lab Test Interference: None

Overdose Management

Signs/Symptoms: Excessive sedation, confusion, ataxia, coma

Treatment: Supportive care, airway management, activated charcoal if ingested recently, and specific antagonist (flumazenil) in certain cases under close monitoring

Storage and Handling

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

Stability: Stable under recommended storage conditions for the duration specified by the manufacturer

🛡️ 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.