501: Sleep Aids and Stimulants
What excludes self-treatment?
-Chronic insomnia (greater than 4 weeks) -Psychiatric issues
What are some side effects of caffeine?
-Diuretic -Nervousness -Tremors -GI -Increased BP
What are some effects of diphenhydramine?
-Dizziness -Blurred vision -Hangover -Constipation
What makes doxylamine and diphenhydramine different?
-Doxy is a category III, not as sedative, not as effective -Same side effects
What is the patient counselling for sleep aids antihistamines?
-Drowsiness -No alcohol -Paradoxical excitation -Short term use of 14 days -Worsen see MD -Maintain healthy sleep habits
What are some side effects of melatonin?
-Hangover -Headache -Depression -Tachycardia -Irritability
What is the dosage for melatonin?
-Insomnia: 0.3-5mg 1-2 hours before bed -Jet lag: 2-5mg evening of arrival and 2-5 days following
Who shouldn't take melatonin?
-MAO inhibitors or seatogenic drugs -Corticosteroids -Lower estrogen/testosterone -Pregnant -Children -Immune system issues
Who should not use diphenhydramine?
-Older men with prostate issues -Glaucoma -Dementia -Anyone over 65
Caffeine: -Rapidly ____ -Peaks in about ____ -Elimination half-life is _____ -Dose ______________ -Max dose _____
-Rapidly absorbed -Peaks in about 30-75 min -3-6 hours -100-200 mg q3-4h -600 mg
Withdrawal symptoms of caffeine include
-Rebound vasodilation -Fatigue -Headache -Tension -Anxiety -Irritability
What are insomnia etiology?
-Stress and anxiety -Psychiatric disorder -Pain -Environment -Jet Lag -Shift work -Age -Drugs -Caffeine
How much caffeine before an overdose?
1 gram
Dose of caffeine
100-200mg for mild stimulation
If insomnia lasts for more than ___, consult physician.
14 days
How much caffeine is safe in a single dose?
200 mg
What is the dose of doxylamine?
25-50 mg
What is the dosage of diphenhydramine?
25-50 mg 30 minutes before bed
Avoid caffeine, nicotine, and alcohol ___ before bed
4-6 hours
Nocturnal melatonin levels decrease with ___.
Age
What are the two pharmacological treatments for insomnia?
Antihistamines and analgesics
Why can't you use alcohol to sleep?
Disrupts sleep in latter part of night, decreases REM sleep
What are the types of antihistamines for insomnia?
Doxylamine; diphenhydramine
Caffeine is considered a ____
Drug and food additive
What is chronic insomnia?
Greater than 2 weeks
___ found in energy drinks contains 4 times the amount of caffeine
Guarana
What is melatonin mainly used for?
Jet-lag and shift work sleep
Recommended dose for pregnancy?
Less than 200 mg per day
What hormone is produced in the pineal gland that helps with sleep?
Melatonin
B6 may induce the production of ___
Melatonin and serotonin
Melatonin is sold as a ____
Nutritional supplement
Caffeine withdrawal: Onset___ Symptoms last ____
Onset: 12-24 hours Symptoms: 1-5 days
Energy drinks mixed with alcohol may induce a feeling of _____ but the patient is still ___
Sobriety, impaired
B6 can induce ____ and ____ and is best to be _____
Vivid dreams and disturbed sleep; avoid
Can milk help with sleep?
Yes, tryptophan
Caffeine's adverse effects along with its ability to hasten ____ and potentially cause ____ imbalances can be dangerous if ingested before physical exertion.
dehydration and electrolyte