Med Card #2 Ramelteon PDF

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Med Card #2 Ramelteon...

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CLASS: Melatonin Receptor Agonist, GENERIC NAME: Ramelteon TRADE NAMES: Rozerem Nonbarbiturate Hypnotic MOA: This drug acts at the MT1 and MT2 receptors to promote sleep and exert an effect on circadian rhythms. INDICATIONS: Used in the management of insomnia characterized by difficulty with sleep onset. It works by affecting certain substances in your body that help regulate your "sleep-wake cycle." CONTRAINDICATIONS/PRECAUTIONS: Hypersensitivity to ramelteon or any ingredient in the formulation, severe sleep apnea, severe hepatic impairment, mild-moderate hepatic impairment, caution if smoking habit change, depression, severe COPD, CNS depressant use, avoid alcohol use INTERACTIONS with other Drugs/Substances: fluconazole or ketoconazole fluvoxamine, butalbital, codeine, doxylamine, eszopiclone, ethanol, hydrocodone, isocarboxazid, kava, Lemborexant, Metoclopramide, midazolam, oxybate, phenelzine, promethazine, suvorexant, thalidomide, tranylcypromine, trimethobenzamide, zaleplon, zolpidem PATIENT RESPONSE / REACTIONS: COMMON SIDE EFFECTS: ADVERSE REACTIONS: S/S TOXICITY: TOXICITY/OVERDOSE TX: suicidal ideation somnolence, fatigue, Ramelteon acts as a DESIRED OUTCOME: dizziness depression exacerbation dizziness, nausea,lethargy, hypnotic and may produce Sleep-promotion and maintenance of somnolence behavioral disturbance worsening/significant CNS cognitive and behavioral the circadian rhythm underlying the fatigue hallucinations depression, hallucinations, changes in individuals. normal sleep-wake cycle. nausea complex sleep-related and risk for injury. Notify the health care insomnia behavior provider immediately if headache anaphylaxis signs of toxicity occur. prolactin elevated anaphylactoid rxn testosterone decrease angioedema cortisol decrease hepatic tumors NURSING ACTIONS: ASSESS: Check for CARE/IMPLEMENT: TEACH: EVALUATE: Monitor for and report worsening decreased insomnia. Assess sleep patterns • Patient should avoid Check for decreased insomnia and cognitive or behavioral Monitor mental status, vital before and periodically activities requiring mental insomnia. Make sure the changes. signs, and assess airways. throughout therapy. alertness or coordination patient is not showing any as drug causes drowsiness. adverse or toxicity signs Monitor for S&S of decreased • Advise patient to report such as increased testosterone levels (e.g., loss of persistent or worsening depression or behavior libido) or increased prolactin levels insomnia, depression, changes. Failure of (galactorrhea). suicidal ideation, or insomnia to remit after a unusual changes in reasonable treatment behavior. period may indicate the • Instruct patient to take presence of an underlying drug within 30 min of psychiatric and/or medical bedtime. Patient should condition requiring avoid taking drug with or evaluation. immediately after a high fat meal.

• Patient should not drink alcohol while taking drug. SPECIAL CONSIDERATIONS/NOTES: Its use is contraindicated in cases of severe liver dysfunction....