Insomnia, Restless legs syndrome (RLS), and Narcolepsy Flashcards
What are the diagnostic criteria for chronic insomnia?
When the patient has symptoms at least 3 times per week for at least 3 months
What medications worsen insomnia?
Acetylcholinesterase inhibitors (donepezil) Alcohol Antiretrovirals Aripiprazole Atomoxetine Bupropion Caffeine Decongestants Diuretics Fluoxetine Steroids Stimulants Varenicline
How to treat insomnia
Non-drug therapy (behavioral therapy)
Treat based on sleep problem (falling and/or staying asleep)
What medications help patients fall asleep
Eszopiclone
Zolpidem
Ramelteon
Zaleplon
What medications help patients stay asleep?
Eszopiclone
Zolpidem
Doxepin
Suvorexant
What medications help patients fall and stay asleep?
Eszopiclone
Zolpidem
What medications are not recommended for chronic use to treat insomnia?
Diphenhydramine Melatonin Tiagabine Trazodone Valerian
What benzos are preferred in the elderly?
LOT
Lorazepam
Oxazapam
Temazepam
What medications are hypnotics used for insomnia? What is their MOA?
MOA: act at benzo receptors to increase GABA, causing CNS depression
Eszopiclone (Lunesta)
Zolpidem (Ambien)
Hypnotic (Eszopiclone and zolpidem) warnings, SE
Warnings: CNS depression, potential for abuse and dependence
SE: somnolence, dizziness, ataxia, parasomnias
What medications are oxerin receptor antagonist? SE?
Suvorexant (Belsomra)
C-IV
SE: somnolence
What medications are melatonin receptor agonists?
Ramelteon (Rozerem)
Tasimelteon (Hetlioz)
Not controlled
SE: somnolence
What tricyclic antidepressant is used in insomnia?
Doxepin
What benzodiazepines are use in insomnia?
Lorazepam (Ativan)
Temazepam (Restoril)
What antihistamines are used in insomnia?
Diphenhydramine (Benadryl)
Doxylamine (Unisom, SLeepTabs)
