PHRD5975 Self-Care: Insomnia, Drowsiness, Fatigue

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Author:
daynuhmay
ID:
264992
Filename:
PHRD5975 Self-Care: Insomnia, Drowsiness, Fatigue
Updated:
2014-03-04 04:54:08
Tags:
Insomnia Drowsiness Fatigue insomnia drowsiness fatigue
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Insomnia, Drowsiness, Fatigue
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  1. insomnia caused by underlying factor (medication, psychiatric, etc)
    secondary insomnia
  2. medical conditions contributing to insomnia
    • 1) depression
    • 2) anxiety
    • 3) asthma
    • 4) COPD
    • 5) sleep apnea
    • 6) heart failure
    • 7) RLS
    • 8) acid reflux
  3. 3 drug classes commonly assoc'd w/ insomnia
    • 1) antidepressants
    • 2) antyhypertensives
    • 3) sympathomimetics
  4. exclusions for self-tx of insomnia
    • <12yo
    • 65yo
    • pregnancy
    • secondary insomnia
  5. non-pharm counsel for tx of insomnia
    • 1) use bed for sleeping only
    • 2) establish regular sleep pattern
    • 3) exercise regularly, but not w/in 2-4hrs before bedtime
    • 4) avoid eating w/in 2hrs of bedtime
    • 5) don't watch the clock at night
  6. MOA of antihistamines for tx of insomnia
    affects sleep through affinity for blocking histamine1 & muscarinic R's
  7. antihistamine tx of insomnia duration NTE...
    7-10 consecutive nights
  8. suggested dosing of antihistamines for tx of insomnia
    25-50mg nightly
  9. antihistamine DDI's (4)
    • decreased clearance of:
    • 1) metoprolol
    • 2) venlaxafine
    • 3) codeine
    • 4) propranolol
  10. antihistamine contraindications (4)
    • 1) BPH
    • 2) narrow-angle glaucoma
    • 3) cardiovascular disease
    • 4) dementia
  11. diphenhydramine pregnancy category
    B
  12. first line tx for insomnia in children/adolescents
    • behavioral interventions
    • good sleep hygiene
  13. complementary therapies for insomnia
    • melatonin
    • valerian

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