Pharm - Insomnia Flashcards
what is insomnia?
dissatisfaction with sleep quality or quantity plus one or more of:
- difficulty falling asleep (sleep onset)
- difficulty staying asleep (sleep maintenance)
- early morning awakening without being able to return to sleep
what are the general principles for administering pharmacological drugs for insomnia
- use the lowest effective dose for the shortest duration
- follow up frequently (3-6 weeks)
- dispense limited supply (80-60 days)
- for those with comorbid insomnia, ensure the underlying condition is adequately treated
What is a sedative?
a drug that reduces excitement and calms the patient. also called aniolytics
What is a hypnotic?
a drug that results in drowsiness that promotes sleep
what is benzodiazepines
GABA-A receptor agonists
what does benzodiazepines do?
enhance the effect of GABA channels and therefore enhances inhibition, allow for enhanced chloride ion movement through GABA receptors
what commonly occurs with discontinuation of benzodiazepines?
rebound insomnia
What is considered the most suitable benzodiazepine that carry Health Canada indication
Temazepam
Trazolam (benzodiazepine) is not recommended because?
it has a higher risk of abuse dependence, and rebound insomnia
Flurazepam and nitrazepam (benzodiazepines) are not recommended due to ?
their long half-lives
What are benzodiazepine receptor agonists (Z-Drugs)?
allosteric modulators of GABA-A receptors
what is generally the preferred drug class for treating people with insomnia?
benzodiazepine receptor agonists (Z-Drugs)
what is the most common Z-drug prescribed in Canada?
Zopiclone
what is a big indicating adverse effect of Z-drugs?
bitter/metallic taste
What is a dual orexin antagonist?
lemborexant
