zolpidem tartrate

(zol' pih dem)

Ambien

Pregnancy Category B
Controlled Substance C-IV

Drug class
Sedative or hypnotic (nonbarbiturate)

Therapeutic actions
Modulates GABA receptors to cause suppression of neurons, leading to sedation,
anticonvulsant, anxiolytic, and relaxant properties.

Indication
• Short-term treatment of insomnia

Contraindications and cautions

• Contraindicated with hypersensitivity to zolpidem.
• Use cautiously with acute intermittent porphyria, impaired hepatic or renal
function, addiction-prone patients, pregnancy, lactation.

Available forms
Tablets—5, 10 mg

Dosages
ADULTS
10 mg PO hs. Do not exceed 10 mg/day.
PEDIATRIC PATIENTS
Safety and efficacy not established.
GERIATRIC PATIENTS
Increased chance of confusion, acute brain syndrome; initiate treatment with 5 mg PO.

Pharmacokinetics
Route Onset Peak
Oral 45 min 1.6 hr

Metabolism: Hepatic; T1/2: 2.6 hr

Distribution: Crosses placenta; may enter breast milk
Excretion: Urine

Adverse effects
• CNS: Seizures, hallucinations, ataxia, EEG changes, pyrexia, morning
drowsiness, hangover, headache, dizziness, vertigo, acute brain syndrome and
confusion; paradoxical excitation, anxiety, depression, nightmares, dreaming,
diplopia, blurred vision, suppression of REM sleep; REM rebound when drug is
discontinued
 • GI: Esophagitis, vomiting, nausea, diarrhea, constipation
• Hypersensitivity: Generalized allergic reactions; pruritus, rash
• Other: Influenza-like symptoms, dry mouth, infection

Nursing considerations
Assessment
• History: Hypersensitivity to zolpidem, acute intermittent porphyria, impaired
hepatic or renal function, addiction-prone patients, lactation, pregnancy
• Physical: T; skin color, lesions; orientation, affect, reflexes, vision exam; P, BP;
bowel sounds, normal output, liver evaluation; CBC with differential; hepatic and
renal function tests

Interventions
• Limit amount of drug dispensed to patients who are depressed or suicidal.
• Withdraw drug gradually if patient has used drug long-term or if patient has
developed tolerance. Supportive therapy similar to that for withdrawal from
barbiturates may be necessary to prevent dangerous withdrawal symptoms.

Teaching points
• Take this drug exactly as prescribed. Do not exceed prescribed dosage. Long-term
use is not recommended.
• These side effects may occur: Drowsiness, dizziness, blurred vision (avoid driving
or performing tasks requiring alertness or visual acuity); GI upset (eat frequent
small meals).
• Report rash, sore throat, fever, bruising.

Adverse effects in Italic are most common; those in Bold are life-threatening.