Sleep disorders

What is narcolepsy

causes person to fall asleep at inappropriate times

What are the symptoms of narcolepsy

sleep attacks

excessive daytime sleepiness

Catalplexy

Sleep paralysis

Excessive dreaming

What is narcolepsy

causes person to fall asleep at inappropriate times

What are the symptoms of narcolepsy

sleep attacks

excessive daytime sleepiness

Catalplexy

Sleep paralysis

Excessive dreaming

What are the treatments for Narcolepsy

1.) Modafinil

2.) Methylphenidate

3.) Dexamfetamine

4.) Sodium oxybate

5.) Pitolisant

What are the side effects of Z-drugs

1.) daytime sleepiness: avoid alcohol makes it worse

2.) avoid long term use- leads to dependence or withdrawal reactions

3.) paradoxical effects: such as hostility or aggression

What’s the MOA of Z-drugs

acts on BZD size of GABA receptors to facilitate and enhance binding of GABA to GABA receptors

What are the 3 types of insomnia

1.) transient insomnia: due to work or jet lag(short acting give 1-2 doses)

2.) short term insomnia: due to emotional problem or illness (PRN doses for max 3 weeks)

3.) chronic insomnia- treat underlying cause

What Z drugs are used for insomnia

zopiclone- 4 weeks use

zolpidem- 4 weeks use

zaleplon- 2 weeks use

short acting hypnotics

What are the short acting BZDs used for insomnia

temazepam

Lorazepam

Oxazepam

What are long acting BZDs

1.) nitrazepam

2.) diazepam

3.) flurazepam

Why should you avoid BZDs or Z- drugs for insomnia in elderly px

leads to ataxia, confusion and falls

What are some other drugs for insomnia

1.) Antihistamines

2.) Melatonin