Pharmacy/sonata

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Question
gisella,the last 2 e-mails I sent you were not returned.i hope they were lost  and not ignored/zaleplon.are they safe.i read about ambien causing upper resporitory infection,is this rare with ambien and sonata.please answer

Answer
Hello,
This issue has only recently come to light, and so it is difficult for me to comment on its frequency of occurrence.  I think it's important to have a basic understanding of pharmacovigilence in order to make an unbiased assessment of whether such an adverse event is plausible.  Remember that pharmaceutical companies are obligated to report every single adverse effect that is made aware to them by the public, both pre- and post-marketing of the drug.  This means EVERYTHING, even if the likelihood of the event actually being caused by the drug is very low.  But it is reported and listed in the product literature mostly as a disclaimer, but also for the 'just in case...you never know, maybe it is the drug' factor.  

At this point, the connection that these drugs have with respiratory infection is unclear, and polls suggest that most clinicians believe it to be unrelated to the drug.  It needs further investigation.  By definition, an infection is caused by a pathogen (a bacteria, virus, or other microbe).  So, in the most simplest of terms, a drug cannot directly "cause" an infection.  However, certain drugs can increase the "risk" of infection.  For example, drugs that suppress the immune system may decrease the body's natural ability to fight infections.  Antibiotics, for instance, can kill good gut flora resulting in an overgrowth of unhealthy bacteria, which causes infection and diarrhoea.  So, there are many examples of drugs causing infections 'indirectly'.

Drugs which cause sedation, if one is severely affected, may compromise rate and depth of respiration.  Opioids, for example, are well-known to have this effect...although it must be said that opioids have an added feature of directly suppressing the respiratory center in the brain, thus complicating the issue.  But if breathing is compromised through sedation, then there could be increased risk of infection. Please understand, that I am not suggesting this is the case for either Ambien or Sonata.  The relationship between these drugs and respiratory infection remains unclear at this point...if indeed there is a relationship!

Sorry, I couldn't offer you a more definitive response with this.  But I'm sure answers will come with time.  For now, the best thing for you to do is to have a good rapport with your physician, take the dose he/she recommends, and always be prepared to report any side effects you may be experiencing.  All the very best.  

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Gisella Campanelli

Expertise

I am able to answer questions relating to pharmaceuticals, therapeutic regimes and primary health care. This includes offering advice on drug indications, dosages, and disease state management. I can also identify side effects, drug interactions and contra-indications, and offer recommendations on ways to mitigate these. I can diagnose minor illnesses and suggest appropriate over-the-counter remedies and/or preventive healthcare tips. I can recognize cardinal symptoms which would otherwise require referral to a medical practitioner.

Experience

I am a registered pharmacist in Australia, and I have practiced in a hospital pharmacy for over thirteen years. My clinical specializations lie within the areas of psychiatry and general medicine (including gastroenterology, respiratory, endocrinology, neurology, infectious diseases, gerontology, dermatology). I self-managed the training program for pharmacy interns in preparation for their final registration exams, and I have worked for the Pharmacy Board of Australia as an examiner and exam writer.

Education/Credentials
I hold a Bachelor of Pharmacy from the Victorian College of Pharmacy, Monash University, and I am board-registered to practice within Australia. I also hold a Master's degree in an unrelated field (art conservation).

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