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Related Concept Videos

Management of Insomnia01:19

Management of Insomnia

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The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
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Insomnia01:27

Insomnia

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Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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Drug Dosing: Geriatric Patients01:15

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Therapy Update for Insomnia in the Elderly.

Sum Lam, Lucy O Macina

    The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
    |October 11, 2017
    PubMed
    Summary
    This summary is machine-generated.

    Insomnia is common in older adults, with non-drug therapies like cognitive behavioral therapy recommended first. Short-term medication may be used cautiously, but hypnotic drugs carry risks for this population.

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    Area of Science:

    • Gerontology
    • Sleep Medicine
    • Pharmacology

    Background:

    • Insomnia frequently affects older adults, yet specific treatment guidelines are often lacking.
    • Identifying appropriate and safe treatment options for geriatric insomnia is crucial.

    Purpose of the Study:

    • To provide an updated overview of insomnia in older adults.
    • To review current treatment options, including pharmacologic and non-pharmacologic approaches.

    Main Methods:

    • A comprehensive literature search was conducted using PubMed with terms 'insomnia' and 'older adults'.
    • English-language articles published between 2012 and February 2017 were reviewed, alongside current clinical guidelines.

    Main Results:

    • Certain medications like anticholinergics, higher-dose doxepin, benzodiazepines (BZDs), and non-BZD receptor agonists (BzDRAs) may be inappropriate for older adults.
    • Cognitive behavioral therapy and sleep hygiene are recommended initial treatments for chronic insomnia.
    • Short-term use of specific BZDs, BzDRAs, low-dose doxepin, ramelteon, or suvorexant may be considered if drug therapy is necessary, with careful risk-benefit discussion and monitoring.

    Conclusions:

    • Non-pharmacologic interventions are the primary treatment for chronic insomnia in older adults.
    • Short-term pharmacotherapy can be an adjunct or alternative, but requires careful consideration of risks.
    • Hypnotic use in the elderly necessitates close monitoring due to potential harms.