Wk 27 - CNS OTC (Insomnia) Flashcards
1
Q
What are the risk factors of insomnia?
A
- Female
- Widowed, divorced
- Lower socioeconomic status
- Inc age
2
Q
What are the types of sleep disorders?
A
- Transient (days)
- ST (3 wks)
- Chronic (> 3 wks - refer)
3
Q
What are the causes of insomnia?
A
- Physical: pain, pregnancy, cough
- Physiological: jetlag, shift work, inc age
- Psychological: stress, bereavement
- Psychiatric: anxiety, depression
- Pharmacological
4
Q
Which drugs cause insomnia?
A
- Caffeine
- Theophylline
- Betablockers
- Antidepressant w/drawal
- Decongestants
- Opiate w/drawal
5
Q
What are the symptoms of insomnia?
A
- Difficulty sleeping
- Difficulty staying asleep: multiple waking, early waking
- Poor quality sleep
6
Q
What sleep hygiene advice can you give a patient?
A
- Keep sleep diary
- Light exercise if early evening
- Avoid caffeine, meals + alcohol close to bedtime
- Go to bed when tired
- Get up same time every morning
7
Q
What is an OTC antihistamine treatment can be given?
A
Diphenhydramine, promethazine:
- 20-30mins before bed
- No more than 14 days
- S/e: anticholinergic, hangover effect
8
Q
When are antihistamines CI?
A
- Prostatic hypertrophy
- Closed angle glaucoma
- Pregnancy + breast feeding
9
Q
What are the counselling points for hypnotics (benzo)?
A
- S/e: day time drowsiness, driving hazard, elderly prone to falls
- Dependence
- W/drawal symptoms: anxiety, insomnia, loss of appetite, N+V
10
Q
Where is melatonin produced in the body?
A
Pineal gland
11
Q
What are the counselling points for insomnia?
A
- Sleep hygiene
- Elderly require less sleep
- Get up if can’t sleep
12
Q
When would you refer for insomnia?
A
- Suspected depression
- Chronic
- <16yrs
13
Q
Give examples of POM treatments
A
- Temazepam, zopliclone
- Lowest dose
- Short course
- W/draw gradually
14
Q
Give examples of natural OTC treatment
A
- Herbal: valerian, passion flower, jamaica dogwood
- Lavender, camomile
- Nasal plasters
