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Nursing Implications for ZALEPLON Sonata

ZALEPLON
(zal′ep-lon)
Sonata
Classifications: ANXIOLYTIC; SEDATIVE-HYPNOTIC; NONBENZODIAZEPINE
Therapeutic: SEDATIVE-HYPNOTIC; ANTIANXIETY
Prototype: Zolpidem
Pregnancy Category: C
Controlled Substance: Schedule IV

AVAILABILITY
Capsule

ACTION & THERAPEUTIC EFFECT
Short-acting nonbenzodiazepine with sedative-hypnotic, muscle relaxant. Reduces difficulty in initially falling asleep. Preserves deep sleep (stage 3 through stage 4) at hypnotic dose with minimal-to-absent rebound insomnia when discontinued.

USES
Short-term treatment of insomnia.

CONTRAINDICATIONS
Hypersensitivity to zaleplon, or tartrazine dye (Yellow 5); severe hepatic impairment; suicidal ideation.

CAUTIOUS USE
Hypersensitivity to salicylates; chronic depression; history of suicidal thoughts; history of drug abuse; COPD; respiratory insufficiency; hepatic impairment; pulmonary disease; older adults; pregnancy (category C); lactation. Safe use in children not established.

NURSING IMPLICATIONS ZALEPLON Sonata

Related for Nursing Implications and Drugs Guide Information

ROUTE & DOSAGE
Insomnia
Adult: PO 10 mg at bedtime (max: 20 mg at bedtime)
Geriatric: PO 5 mg at bedtime (max: 10 mg at bedtime)

ADMINISTRATION
Oral

Give immediately before bedtime; not while patient is still ambulating.
Ensure that extended release tablets are swallowed whole and are not crushed or chewed.
Sublingual tablets should not be given with water and should not be swallowed
Oral spray container must be primed before first use. Ensure that a full dose (5 mg) is sprayed directly into the mouth over the tongue. For a 10 mg dose, administer a second spray.
Store at 20°–25° C (68°–77° F).

ADVERSE EFFECTS (≥1%)

Body as a Whole: Asthenia, fever, headache, migraine, myalgia, back pain. CNS: Amnesia, dizziness, paresthesia, somnolence, tremor, vertigo, depression, hypertonia, nervousness, difficulty concentrating. GI: Abdominal pain, dyspepsia, nausea, constipation, dry mouth. Respiratory: Bronchitis. Skin: Pruritus, rash. Special Senses: Eye pain, hyperacusis, conjunctivitis. Urogenital: Dysmenorrhea.

INTERACTIONS

Drug: Alcohol, imipramine, thioridazine may cause additive CNS impairment; rifampin increases metabolism of zaleplon; cimetidine increases serum levels of zaleplon. Herbal: Valerian, melatonin may produce additive sedative effects. Food: High-fat meals may delay absorption.

PHARMACOKINETICS

Absorption: Rapidly and completely absorbed, 30% reaches systemic circulation. Onset: 15–20 min. Peak: 1 h. Duration: 3–4 h. Distribution: 60% protein bound. Metabolism: Extensively in liver (CYP3A4) to inactive metabolites. Elimination: 70% in urine, 17% in feces. Half-Life: 1 h.

NURSING IMPLICATIONS

Assessment & Drug Effects

Monitor behavior and notify prescriber for significant changes. Use extra caution with preexisting clinical depression.
Provide safe environment and monitor ambulation after drug is ingested.
Monitor respiratory status with preexisting compromised pulmonary function.

Patient & Family Education

Exercise caution when walking; avoid all hazardous activities after taking zaleplon.
Do not take in combination with alcohol or any other sleep medication.
Note: Exhibits altered effectiveness if taken with/immediately after high-fat meal.
Do not use longer than 2–3 wk.
Expect possible mild/brief rebound insomnia after discontinuing regimen.
Report use of OTC medications to prescriber (e.g., cimetidine).
Report pregnancy to prescriber immediately.

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