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Asked by JusticeRose3200

A 55-year-old female comes to see you with complaints that she is not sleeping well. She has not slept more than 4 hours a night for the past 3 to 4 weeks. After fully assessing her, you discover that she has recently lost her husband of 30 years.

What non habit-forming drugs (including OTCs) would you consider if her insomnia was just intermittent?

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What are two drug classes you would consider for this acute insomnia problem?

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What is the first drug in each of those classes to try? Why?

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What are the most common side effects of these drug classes? How do you mitigate these?

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What teaching do you need to give patients prescribed these drugs?

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Would you need to dose the drug, zolpidem, different for a female than for a male? Why or why not?

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Would that drug classification choice be different if the patient was 80 years old?

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Would you consider Belsomra? Why or why not?

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What are the differences between Z drugs and benzodiazepines?

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Which of the Z-drugs has the shortest half-life?

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The patient returns in 1 month. Although she is better and is seeing a therapist, she is continuing to have insomnia regularly. She admits that she has actually had trouble with anxiety and insomnia for years and feels she may need to take the medications long term. You know you need to treat her anxiety.

Would you change what drug classification you are giving? Why or why not?

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Which of the insomnia drugs does NOT cause dependency?

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You have a new patient that has been taking lorazepam 2 mg twice daily for the last 5 years. The patient would like to discontinue the benzodiazepine, but has heard that she can’t just stop the medication abruptly. 

Is that true? Why or why not? 

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What will be your general plan for discontinuation of the medication? 

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