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What neurotransmitters control sleep? How?
- Serotonin and Norepinephrine
- Keep parts of the brain active while we are asleep
- Builds up while we are awake and causes drowsiness, broken down while we are asleep
How many sleep stages exist?
5 (1-4 and REM)
50% of our sleep is spent in what stage?
20% of our sleep is spent in what stage?
What stage: light sleep, awaken easily, eye movement slows?
In what stage does eye movement stop and the brain waves are slower?
In what stage is there no eye movement and brain waves continue to slower?
What stage is considered "deep" sleep?
Describe the REM stage.
- Breathing rapid/shallow
- Eyes jerk
- Limbs paralyzed
- HR/BP increased
- Male erections
What are some things that affect sleep?
- Too hot/cold
When do women need more sleep?
In the first trimester of pregnancy.
How many hours of sleep does an average person get?
What are some symptoms of too little sleep?
- Hand/eye coordination impairment
- Lack of concentration
- Unable to function
What are 4 types of sleep disorders?
- Obstructive Sleep Apnea (OSA)
- Restless Legs Syndrome
What percentage of women have insomnia? Men?
What is a factor that increases the chances of insomnia?
Increase in age
What are symptoms of insomnia disorders?
- Difficulty falling asleep
- Waking during sleep
- Early-morning awakenings
- Produces impairment in next-day activities
What are some tips for a goodnight sleep?
Set a night-time schedule, avoid naps, exercise during the day, relax before bed, sleep until sunlight, don't lie in bed awake, control room temp
What are 3 Nonbenzodiazepine GABAergic Sedatives?
- Ambien (CR)
- Sonata (Zaleplon)
What are example classes of sleep medications?
- Nonbenzodiazepine GABAergic sedatives
- Benzodiazepines (reduce stages 3 and 4)
- Antidepressants: tricyclic antidepressants, Mirtazapine, Trazodone)
- Melatonin: Rozerem (Ramelteon)
What class is Zolpidem?
Is Zolpidem absorbed rapidly or slowly from the GI tract? What is the onset of action?When should it be taken?
- Rapid absorption and a short elimination half-life
- Onset of action = 30 minutes
- Take immediately before bedtime.
What are the effects of benzodiazepines?
Affect GABA--> induces sleep
What antihistamines are commonly used for a sleep aid? What is a side effect?
- Diphenhydramine, Doxylamine
- Next day drowsiness
What is sleep apnea?
A serious sleep disorder in which breathing repeatedly stops and starts
What are some symptoms of sleep apnea?
Excessive daytime sleepiness, loud snoring, observed episodes of breathing cessation during sleep, abrupt awakenings accompanied by SOB, waken with a dry mouth or sore throat, morning headache, difficulty staying asleep, uncontrollable hypertension
What are risk factors for sleep apnea?
- Size of neck circumference
- Narrow airway
- > 65 years of age
- Using alcohol or smoking
What is a polysomnogram?
Sleep study for sleep apnea that records brain and body activity during sleep to help diagnose and treat sleep disorders
What are treatment options for OSA?
- Positional therapy
- Weight loss
- Avoid alcohol
What is conjunctivitis?
Redness or irritation of the membranes on the inner part of the eyelids and the membranes covering the whites of the eye.
What are causes of pink eye?
- allergy-provoking agents
- toxic agents
- underlying diseases
What are common symptoms of pink eye?
- watery eyes and discharge
- usually starts with one eye and then spreads
What treatment options are available for bacterial pink eye?
- Vigamox (Moxifloxacin)
- Zymar (Gatifloxacin)
- TobraDex (Tobramycin with Dexamethasone)
- Ciloxan (Ciprofloxacin)
What treatment option is available for allergic pink eye?
What are the two types of glaucoma?
- Open angle
- Closed angle (emergency)
What causes glaucoma?
Damage to the optic nerve causes an increase in intraocular pressure which results in vision loss
Are there always symptoms present for glaucoma?
What type of ophthalmic drops are used in treating glaucoma?
- Alpha Agonists
- Prostaglandin Analogs
- Cholinesterase Inhibitors
Can eyedrops for glaucoma be used with contacts?
No--must be removed for 15 minutes
List some of the autoimmune disorders.
- Addison's disease
- Type 1 diabetes
- Grave's disease
- Celiac disease
- Pernicious anemia
- Rheumatoid arthritis
- Chrohn's disease
How do we treat autoimmune diseases?
- Decrease symptoms and control the process
- Reduce the immune response
What are some common immunosuppressant medications?
What are the strongest drugs available to reduce inflammation and decrease the body's ability to fight infection?
How are corticosteroids often seen?
- Creams and ointments
- Asthma medications
What are counseling points for corticosteroids?
- Tapered Dose
- Do not discontinue abruptly
- Take with food
- Many side effects
- Autoimmune disorders
- Autoimmune disorders
- Autoimmune disorders