Sedative Hypnotic: Melatonin Receptor Agonists, Pregos and Other classes

Question 1

The next class of drugs are the Melatonin Receptor Agonists. The only drug in this category is Ramelteon. What are some features?

Answer 1

1. Agonist at MT1 and MT2 melatonin receptors
2. Activity at these receptors contributes to sleep promoting properties
3. Should not be given concurrently with fluvoxamine which inhibits CYP1A2
4. Indicated for treatment of insomnia characterized by difficulty with sleep onset
5. AE: dizziness, somnolence, fatigue
6. Min abuse potential

Question 2

What drugs are and are not used in pregos in regards to sedative-hypnotics?

Answer 2

Teratogenicity:
–benzos are either category D or X. Temazepam, Triazolam, and Flurazepam are X
Most Barbiturates are D
Eszopiclone, zaleplon, zolpidem and ramelteon are C
Buspirone is B

Question 3

Over the years many drug with diverse structures have been used for their sedative hypnotic properties. These drugs include?

Answer 3

Chloral Hydrate
Meprobamate
Paraaldehyde

Question 4

Hydroxyzine is an antihistamine with antiemetic activity. What else can it be used for?

Answer 4

Approved for symptomatic relief of anxiety and tension associated with psychoneruosis and as an adjunct in organic disease states in which anxiety is manifested

Question 5

Propanolol and other beta adrenergic receptor antagonists can reduce the autonomic symptoms associated with what?

Answer 5

Specific situational phobias

–controls performance anxiety (Stage fright)

Question 6

Diphenhydramine and Doxylamine, are effective in treating mild insomnia, but what?

Answer 6

Usually ineffective for all but the milder forms of situational insomnia
–they have numerous undesirable side effects