Sedative-Hypnotics

Psychiatric

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Examples

zolpidem (Ambien)eszopiclone (Lunesta)ramelteontrazodone

Prefix / Suffix: Z-drugs often start with 'z-'

Physiology

Insomnia is often associated with psychiatric disorders. Sedative-hypnotics promote sleep through GABA enhancement or melatonin receptor activity.

Mechanism of Action

Z-drugs bind GABA-A receptors to induce sleep. Ramelteon is a melatonin receptor agonist. Trazodone blocks serotonin and histamine receptors.

Indications

Short-term insomnia
Difficulty initiating or maintaining sleep
Sleep disturbance in depression (trazodone)

Side Effects / Adverse Effects

Daytime drowsiness, dizziness
Complex sleep behaviors (sleep-walking, sleep-driving — Z-drugs)
Dependence (Z-drugs with prolonged use)
Priapism (trazodone — rare)
Rebound insomnia

Contraindications

Severe respiratory impairment
Untreated sleep apnea
Concurrent CNS depressants/alcohol

Nursing Considerations

Give immediately before bedtime with at least 7–8 hours for sleep
Avoid alcohol and CNS depressants
Use short-term to prevent dependence (Z-drugs)
Educate about complex sleep behaviors — discontinue if they occur
Combine with sleep hygiene measures
Caution in elderly — fall risk

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.