Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Zolpidem belongs to a class of drugs called
sedatives or hypnotics. Zolpidem shares some characteristics of a family of
sedatives called benzodiazepines. Benzodiazepines cause sedation, muscle
relaxation, act as anti-convulsants (anti-seizure medications), and reduce
anxiety. Zolpidem has selectivity in that it has little of the muscle relaxant
and anti-seizure effects and more of the sedative effect. Therefore, it is used
primarily as a medication for sleep. The oral spray form of zolpidem, Zolpimist,
has more rapid absorption than the tablet form because it is absorbed through
the lining of the mouth. The FDA approved zolpidem in December 1992.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATION: Tablets: 5 and 10 mg. Tablet (extended release): 6.25 mg and
12.5 mg. Oral spray: 5 mg/spray
STORAGE: Zolpidem should be stored at room temperature, 20-25 C (68-77 F), in
an air-tight container.
PRESCRIBED FOR: Zolpidem is used for treating insomnia. Conventional tablets
are used for short-term treatment of insomnia associated with difficulty falling
asleep. Long acting tablets are used for treating insomnia associated with
difficulty falling asleep or staying asleep. Zolpidem improves initiation of
sleep and keeps patients asleep longer.
DOSING: The recommended adult dose of zolpidem is 10 mg as conventional
tablets or spray or 12.5 mg as extended-release tablets. In elderly patients, an
initial dose of 5 mg as conventional tablets or 6.25 mg as extended-release
tablets is recommended because elderly patients have decreased ability to
eliminate zolpidem from the body, and accumulating zolpidem may cause side
effects.
DRUG INTERACTIONS: Alcohol has an additive effect with zolpidem and the two
should not be combined. Zolpidem should not be combined with other sedative
drugs because of the additive effects. Itraconazole
(Sporanox) and ketoconazole (Nizoral, Extina, Xolegel, Kuric) may
increase the blood concentration of zolpidem by reducing the activity of the
enzymes that breakdown zolpidem in the liver. Conversely, rifampin may reduce
the concentration of zolpidem by increasing the activity of of the enzymes that
breakdown zolpidem.
PREGNANCY: There are no adequate studies of zolpidem use in
pregnant women.
NURSING MOTHERS: Zolpidem is excreted in human
breast milk and may adversely
affect the infant.
SIDE EFFECTS: The most common side effects of zolpidem are drowsiness,
dizziness, and a "drugged" feeling, which probably reflect the action of the
drug. Other side effects include confusion, insomnia, euphoria, ataxia (balance
problems), and visual changes. Zolpidem can cause withdrawal symptoms (muscle
cramps, sweats, shaking, and seizures) when the drug is abruptly discontinued.
Zolpidem can cause abnormal behavior with confusion, paradoxical insomnia or
"complex sleep-related behaviors," which may include sleep-driving (driving with
no memory of having done so). If these side effects occur, zolpidem should be
discontinued.
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Insomnia is difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are medications, psychological conditions, environmental changes and stressful events. Treatments may include non-drug treatments, over-the-counter medicines, and/or prescription medications.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Sleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
Insomnia is defined as difficulty initiating or maintaining
sleep, or both,
despite adequate opportunity and time to sleep, leading to impaired daytime
functioning. Insomnia may be due to poor quality or quantity of sleep.
Insomnia is very common and occurs in 30% to 50% of the general population.
Approximately 10% of the population may suffer from chronic (long-standing)
insomnia.
Insomnia affects people of all ages including children, although it is more
common in adults and its frequency increases with age. In general, women are
affected more frequently than men.
Insomnia may be divided into three classes based on the
duration of symptoms.
Insomnia lasting one week or less may be termed transient
insomnia;
short-term insomnia lasts more than one week but resolves in less
than three weeks; and
long-term or chronic insomnia lasts more than three we...
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