Chapter 11 Insomnia Sample Questions
1. MP is an 85-year-old patient complaining about taking him one hour to fall asleep. He also has osteoarthritis, hypertension, high cholesterol, and diabetes. He wants a medication that can help initiate sleep without hangover effect in the morning. His lifestyle includes brisk walking before bedtime. What is your best recommendation?
- A. Zopiclone 7.5 mg PRN
- B. Oxazepam
- C. Flurazepam
- D. Lorazepam
Ans:
B
Tips: TOT: Temazepam, Oxazepam and Triazolam. No hangover effects.
Zopiclone most common side effects, difficulty in waking up in the morning (1%), bitter taste (15-30%) and dry mouth (5%). Has residual hangover effect.
Although the number of comparative studies is relatively small, oxazepam is as effective as the benzodiazepines that are officially indicated for insomnia. In patients with initial insomnia, oxazepam should be given 60–90 minutes before bedtime because of its slow absorption, although patients should be aware that some sedation/impairment could occur before this time. Conversely, patients who have no difficulty falling asleep but experience maintenance insomnia can take oxazepam when getting into bed
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