জোলপিডেম টারটারেট (Zolpidem) এ আছে Zolpidem (জোলপিডেম টারটারেট)। জোলপিডেম টারটারেট (Zolpidem) এর কাজ, খাওয়ার নিয়ম, পার্শ্বপ্রতিক্রিয়া, মাত্রা ও সেবনবিধি, সতর্কতা, মিথষ্ক্রিয়া, গর্ভাবস্থায় ও স্তন্যদানকালে ব্যবহার, মাত্রাধিক্যতাঃ
Zolpidem is an imidazopyridine derivative that acts by binding to the benzodiazepine (BZD) receptors of the GABA receptor complex resulting in neuronal hyperpolarisation, action potential inhibition, increased in chloride conductance and decreased in neuronal excitability. It has strong sedative action but only minimal anxiolytic, myorelaxant and anticonvulsant properties due to its selectivity for the BZ1-receptor over the BZ2-receptor. Zolpidem has a rapid onset but short duration of hypnotic action.
কাজ
.জোলপিডেম অনিদ্রার স্বল্পমেয়াদী চিকিৎসার জন্য নির্দেশিত । জোলপিডেম নিয়মিত ক্লিনিক্যাল গবেষণায় ৩৫ দিন পর্যন্ত ঘুম দেরিতে হওয়া হ্রাস দেখানো হয়েছে , কার্যকারিতা সমর্থনে ক্লিনিক্যাল যে গবেষণা গুলো সঞ্চালিত হয়েছিল তার ব্যপ্তিকাল ৪-৫ সপ্তাহ ছিল ।
থেরাপিউটিক ক্লাস
Miscellaneous sedatives & hypnoticsমাত্রা ও সেবনবিধি
Dosage In Adults: Use the lowesteffective dosefor the patient. The recommended initial dose is 5 mg for women and either 5 or 10 mg for men, taken only once per night immediately before bedtime with at least 7–8 hours remaining before the planned time of awakening. If the 5 mg dose is not effective, the dose can be increased to 10 mg. In some patients, the higher morning blood levels following use of the 10 mg dose increase the risk of next day impairment of driving and other activities that require full alertness. The total dose of Zolpidem should not exceed 10 mg once daily immediately before bedtime. Zolpidem should be taken as a single dose and should not be readministered during the same night.The recommended initial doses for women and men are different because zolpidem clearance is lower in women.Special Populations: Elderly or debilitated patients may be especially sensitive to the effects of zolpidem tartrate. The recommended dose of Zolpidem in these patients is 5 mg once daily immediately before bedtimePatients with mild to moderate hepatic impairment do not clear the drug as rapidly as normal subjects. The recommended dose of Zolpidem in these patients is 5 mg once daily immediately before bedtime. Avoid Zolpidem use in patients with severe hepatic impairment as it may contribute toencephalopathyUse With CNS Depressants: Dosage adjustment may be necessary when Zolpidem is combined with other CNS depressant drugs because of the potentially additive effects
জোলপিডেমের প্রভাব খাওয়ার সাথে বা তাৎক্ষণিক ভাবে ইনজেকশন এর দ্বারা ধীর করা যায় ।
পার্শ্ব প্রতিক্রিয়া
Atypical thinking and behaviour, hallucination, nightmare, somnolence, somnambulism, headache, nausea, vomiting, dizziness, vertigo, drowsiness, asthenia, ataxia, rebound insomnia, amnesia, GI disturbances, upper and lower respiratory tract infection, fatigue, visual disturbances, increased ALT serum concentrations, abnormal LFT.
সতর্কতা
Obstructive sleep apnoea, myasthenia gravis, compromised respiratory function. Patients exhibiting symptoms of depression. History of drug or alcohol abuse. Avoid abrupt withdrawal and rapid dose reduction after prolonged therapy. Re-evaluate if insomnia fail to remit after 7-10 days as this may indicate the presence of underlying psychiatric and/or medical condition. Pregnancy, lactation, childn <18 yr.
ঔষধের মিথষ্ক্রিয়া
Co-administration of zolpidem with other CNS depressants increases the risk of CNS depression. Concomitant use of zolpidem with these drugs may increase drowsiness and psychomotor impairment, including impaired driving ability. Zolpidem tartrate was evaluated in healthy volunteers in single-dose interaction studies for several CNS drugs.Imipramine, Chlorpromazine: Imipramine in combination with zolpidem produced no pharmacokinetic interaction other than a 20% decrease in peak levels of imipramine, but there was an additive effect of decreased alertness. Similarly, chlorpromazine in combination with zolpidem produced no pharmacokinetic interaction, but there was an additive effect of decreased alertness and psychomotor performanceHaloperidol: A study involving haloperidol and zolpidem revealed no effect of haloperidol on the pharmacokinetics or pharmacodynamics of zolpidem. The lack of a drug interaction following single-dose administration does not predict the absence of an effect following chronic administrationAlcohol: An additiveadverse effecton psychomotor performance between alcohol and oral zolpidem was demonstratedSertraline: Concomitant administration of zolpidem and sertralineincreases exposure to zolpidemFluoxetine: After multiple doses of zolpidem tartrate and fluoxetine an increase in the zolpidem half-life (17%) was observed. There was no evidence of an additive effect in psychomotor performance
গর্ভাবস্থায় ও স্তন্যদানকালে ব্যবহার
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
মাত্রাধিক্যতা
Symptoms: Drowsiness, impairment of consciousness from somnolence to coma, compromised CV and respiratory function. Management: Treatment is largely symptomatic and supportive. IV fluids should be administered as needed. Activated charcoal may be given if presented w/in 1 hr of ingestion of >1 mg/kg zolpidem in adults or childn. Gastric lavage may be considered if presented w/in 1 hr of ingestion of >100 mg zolpidem and monitor for at least 12 hr. Flumazenil may be used if there is severe CNS depression, but generally not needed. Haemodialysis is unlikely to be useful.
বিশেষ সতর্কতা
পেডিয়াট্রিকের ব্যবহার: জোলপিডেম বাচ্চাদের ব্যবহারের জন্য প্রস্তাবিত নয়। 18 বছরের কম বয়সী পেডিয়াট্রিক রোগীদের জন্য জোলপিডেমের সুরক্ষা এবং কার্যকারিতা প্রতিষ্ঠিত হয়নি।
সংরক্ষণ
২০ থেকে ২৫ ডিগ্রী সেলসিয়াস তাপমাত্রায় সংরক্ষণ করুন ।