单词 | eszopiclone | ||||||||
释义 | eszopiclonees·zo·pic·loneE5229250 (ĕs′zō-pĭk′lōn)eszopicloneeszopiclonePharmacologic class: Nonbenzodi-azepine Therapeutic class: Hypnotic Controlled substance schedule IV Pregnancy risk category C ActionUnclear. Effect may result from interaction with GABA-receptor complexes at binding domains near or allosterically coupled with benzodiazepine receptors. AvailabilityTablets: 1 mg, 2 mg, 3 mg Indications and dosages➣ Insomnia Nonelderly adults: 2 mg P.O. immediately before bedtime. Drug may be initiated at, or dosage may be increased to, 3 mg if indicated clinically. In patients also receiving potent CYP3A4 inhibitors, starting dosage shouldn't exceed 1 mg. Elderly adults: 1 mg P.O. immediately before bedtime. Dosage may be increased to 2 mg if indicated clinically. If patient's chief complaint is difficulty staying asleep, recommended dosage is 2 mg P.O. immediately before bedtime. Dosage adjustment• Hepatic impairment • Concomitant use of other CNS depressants ContraindicationsNone PrecautionsUse cautiously in: • hepatic impairment, respiratory compromise, depression • pregnant or breastfeeding patients • children younger than age 18 (safety and efficacy not established). Administration• Don't give with or immediately after a heavy, high-fat meal because this may slow drug absorption and reduce efficacy. ![]() Adverse reactionsCNS: headache, anxiety, confusion, depression, dizziness, hallucinations, nervousness, abnormal dreams CV: chest pain, peripheral edema GI: nausea, vomiting, diarrhea, dyspepsia, cholelithiasis, dry mouth GU: urinary tract infection, decreased libido, dysmenorrhea, gynecomastia (in males) Respiratory: respiratory infection Skin: rash, pruritus Other: unpleasant taste, viral infection, neuralgia, facial edema, allergic reaction InteractionsDrug-drug. CYP3A4 inhibitors (such as itraconazole, ketoconazole, ritonavir, troleandomycin): increased eszopiclone blood level CYP3A4 inducers (such as rifampin): decreased eszopiclone blood level Drug-food. Heavy, high-fat meal: slowed drug absorption and reduced efficacy Drug-behaviors. Alcohol use: additive effects on psychomotor performance Patient monitoring• Before starting therapy, evaluate patient to help eliminate physical or psychiatric causes of insomnia. • Know that after rapid dosage decrease or abrupt drug withdrawal, patient may experience signs and symptoms similar to those associated with withdrawal from other CNS depressants. Patient teaching• Instruct patient not to take drug with or immediately after a heavy, high-fat meal. • Advise patient to take drug immediately before bedtime; otherwise, shortterm memory impairment, hallucinations, incoordination, dizziness, and light-headedness may occur. • Caution patient not to engage in hazardous activities after taking drug. • Tell patient drug may have some effect the next day; advise him to use extreme care when driving or performing other hazardous activities until drug effects are known. • Caution patient not to take drug with other psychotropics, anticonvulsants, antihistamines, or other drugs that cause CNS depression. • Advise patient not to take drug with alcohol. • As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, foods, and behaviors mentioned above. eszopiclone(es-zop-i-klone) eszopiclone,Lunesta(trade name)ClassificationTherapeutic: sedative hypnoticsPharmacologic: cyclopyrrolones IndicationsActionTherapeutic effectsPharmacokineticsTime/action profile (blood levels)
Contraindications/PrecautionsAdverse Reactions/Side EffectsCentral nervous system
Cardiovascular
Gastrointestinal
Dermatologic
InteractionsDrug-Drug interaction↑ risk of CNS depression with other CNS depressants including antihistamines, antidepressants, opioids, sedative/hypnotics, and antipsychotics.↑ levels and risk of CNS depression with drugs that inhibit the CYP3A4 enzyme system, including ketoconazole, itraconazole, clarithromycin, nefazodone, ritonavir, and nelfinavir.Levels and effectiveness may be ↓ by drugs that induce the CYP3A4 enzyme system, including rifampin.Route/DosageHepatic ImpairmentOral (Adults) Severe hepatic impairment—1 mg immediately before bedtime.Availability (generic available)Nursing implicationsNursing assessment
Potential Nursing Diagnoses(Indications)Implementation
Patient/Family Teaching
Evaluation/Desired Outcomes
eszopiclone(ĕs′zō-pĭk′lōn) |
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