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30 Cards in this Set

  • Front
  • Back
insomnia self treatment
alcohol
diphenhydramine
doxylamine
metalonin
natural product
valeria, kavakava
alcohol treatment
- low sleep latency
- up total sleep time
- fragment sleep
- low quality
otc treatment
- up sleep maintenance
- up total sleep time
- no effect on sl
- anti chole AE
- tolerance
melatonin treatment
- low sl
- regular rhythm
not fda regulated
SE fatigue, dz, ha
contraindication pragnance, cvd, immuno suppress
natural product treatment
- no data for efficacy
- valerian:
late onset
livertoxic
delirium
- kavakava
livertoxic
- l trytophan
death
treatment of acute insomnia
- remove underlying cause
- use short time
- 4-6wk
- sleep hygeine
sleep hygeine
- no nap
- routine time
- no everning exercise
- no stimulants
- prepare to sleep
- good bedroom
chronic insomnia treatment
- find and treat 2ndary causes
- start non phar 1st
- start intermittent shorterm (2-3dprn)
- reassess
- may go to sleep study
non pharmaco tx
cognitive bahavioural tx
(cbt)
- affect as med for shorterm
- last >6mo
for sleep onset bzd
bzd
- short acting: triazolam
- inter acting
estazolam
temazolam
sleep onset bzra
bzd recetor agonist
- zaleplon
- zolpidem (pregnancy)
- eszopiclone
sleep onset other med
remalteon
doxepin
insomnia maintenance
- bzd
- bzra (no zaleplon)
- doxepin
shorterm insomnia guideline with bzra
- non phar tx 1st
- short hypnotic
- cheapest one
- switch if AE
- dont switch if no response
insomnia in elderly and children
- trial elderly: bzra better bzd
- no trial on children
bzd short acting and AE
short acting
- memory
- amnesia
- withdraw 24hr
- rebound 1-2 days
- tolerance 1-2wks
bzd long acting and AE
- respiratory depress
- hangover effect
- withdraw 3-8days
- tolerance 1-3mi
parasomnia problem
- sleep walk
- sleep eating
- sleep driving
- memory loss
parasomnia drug link
zolpidem - interaction w valproic acid
zaleplon overdose
short acting bzd
alcohol
FDA label regulation
- behaviour change
- anaphylaxis
other drug use
trazodone
< 2wks
patient education
medication relate
- avoid fatty meal
- take before sleep
- use intermittent only
- drug interaction
rhythm disorder tx
melatonin
FDA for blindness
delay sleep phase
advance sleep phase (not for elderly)
jet lag
shilf switch
rhythm disorder non phar tx
light
sleep hygeine
sleep apnea non phar tx
mild
- position
moderate / severe
- Cpap
- weight loss
- surgery if cpap doesnt work
sleep apnea phar tx
- no cns depressant
- modafinil
- bzra w cpap
- topical nasal corticosteroid
NOT RECOMMENDED FOR SLEEP APNEA
- PROTRIPTYLINE
- AMINOPHYLLINE
- THEOPHYLINE
- ESTROGEN
- OXYGEN
- NASAL DICONGESTANT
rls and rlmd tx
iron 325bid
levodopa
dopamin agonist
- ropinirole (liver cl)
- pramipexole (renal cl)
rls/plmd 2nd line
- opioid
- bzd, bzra
- anticonvulsant
- life time modify
narcolepsy drug
- modafinil
- dextroamphetamine
- oxybate for cataplexy
central pharmacy only
or tca, ssri