Pharmacology: Diphenhydramine Counseling Points and Contraindications (CAM)
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Questions and Answers

Which of the following medications is LEAST likely to cause insomnia as a side effect?

  • Antidepressants (e.g., bupropion, fluoxetine, venlafaxine)
  • Caffeine
  • Melatonin (correct)
  • Phentermine

    • A patient with insomnia due to stress is prescribed a beta-blocker medication. Which of the following is the most likely mechanism by which the beta-blocker can improve the patient's sleep?

  • The beta-blocker blocks the stimulant effects of caffeine, reducing insomnia.
  • The beta-blocker inhibits the release of cortisol, the stress hormone that can disrupt sleep.
  • The beta-blocker has a direct sedative effect on the central nervous system, inducing drowsiness.
  • The beta-blocker reduces heart rate and blood pressure, promoting relaxation and easier sleep onset. (correct)

    • Which of the following complementary and alternative medicine (CAM) therapies has the strongest evidence for improving sleep quality in patients with insomnia?

  • Cognitive-behavioral therapy (CBT)
  • Melatonin (correct)
  • Acupuncture
  • Herbal supplements (e.g., valerian, chamomile)

    • A patient with insomnia is prescribed a low-dose melatonin supplement. Which of the following is the most important consideration when using melatonin for insomnia?

    <p>Melatonin may interact with certain medications, such as blood thinners.</p> Signup and view all the answers

    A patient with insomnia due to hypertension and dyslipidemia is prescribed a combination of lisinopril/HCTZ and atorvastatin. Which of the following is the most likely mechanism by which these medications can contribute to the patient's insomnia?

    <p>Lisinopril/HCTZ and atorvastatin have no direct effect on sleep, and the patient's insomnia is likely due to the underlying medical conditions.</p> Signup and view all the answers

    A patient with insomnia is prescribed a low-dose melatonin supplement. Which of the following is the most important consideration when dosing melatonin for insomnia?

    <p>The optimal dose of melatonin for insomnia varies greatly between individuals and should be titrated accordingly.</p> Signup and view all the answers

    Which of the following is the most appropriate pharmacologic treatment for transient and short-term insomnia, according to the information provided?

    <p>Diphenhydramine</p> Signup and view all the answers

    What is the mechanism of action of diphenhydramine in treating insomnia?

    <p>It competes with histamine for H1-receptor sites on effector cells</p> Signup and view all the answers

    What is the recommended dosage of diphenhydramine for the treatment of transient and short-term insomnia?

    <p>50 mg at bedtime, with the option of 25 mg if needed</p> Signup and view all the answers

    According to the information provided, what is the maximum recommended duration for consecutive use of diphenhydramine in treating insomnia?

    <p>7-10 days</p> Signup and view all the answers

    Which of the following is NOT listed as a potential side effect of diphenhydramine in the treatment of insomnia?

    <p>Insomnia</p> Signup and view all the answers

    According to the information provided, what is recommended for the treatment of insomnia that is not transient or short-term?

    <p>Nonpharmacologic treatment</p> Signup and view all the answers

    Which of the following beverages/supplements contains the highest amount of caffeine per serving?

    <p>Metabofit Blend</p> Signup and view all the answers

    What is the maximum recommended daily caffeine intake for children, according to the text?

    <p>2.5mg/kg/day</p> Signup and view all the answers

    Which of the following statements about caffeine consumption during pregnancy is true, based on the information provided?

    <p>Moderate consumption of ≤ 200mg/day is acceptable</p> Signup and view all the answers

    Which of the following over-the-counter medications contains the highest amount of caffeine per dose?

    <p>NoDoz Maximum Strength and Vivarin</p> Signup and view all the answers

    Which of the following statements about caffeine consumption in older adults is true, according to the text?

    <p>Older adults experience exaggerated pharmacologic effects and sleep interference from caffeine</p> Signup and view all the answers

    Based on the patient case provided, what would be the appropriate response to T.J.'s question about taking NoDoz Maximum Strength in the afternoon?

    <p>Advise against taking NoDoz Maximum Strength due to his post-heart attack condition and current medications</p> Signup and view all the answers

    What is the recommended approach for managing insomnia in children under 12 years old?

    <p>Avoid using diphenhydramine and doxylamine for children under 12.</p> Signup and view all the answers

    What can be an effect of mothers ingesting sedating antihistamines while breastfeeding?

    <p>Increased risk of paradoxical excitation in infants.</p> Signup and view all the answers

    Why should oral and topical diphenhydramine not be used together in children?

    <p>Due to the risk of toxicity.</p> Signup and view all the answers

    What does the Beers criteria advise regarding anticholinergics use in older adults?

    <p>Suggests avoiding anticholinergics due to cognitive impairment and falls risk.</p> Signup and view all the answers

    What is the AASM's recommendation regarding diphenhydramine use for insomnia?

    <p>Weakly recommends against diphenhydramine for insomnia.</p> Signup and view all the answers

    What is a potential consequence of using sedating antihistamines in breastfeeding mothers?

    <p>Increased risk of drowsiness in breastfed infants.</p> Signup and view all the answers

    What is the usual recommended dose of melatonin for treating insomnia?

    <p>0.3-5 mg at bedtime</p> Signup and view all the answers

    For which of the following patient populations is there the BEST evidence for the effectiveness of melatonin in treating insomnia?

    <p>Patients with neurological disorders, the elderly, depression, or jet lag</p> Signup and view all the answers

    Which of the following statements about the use of valerian (Valeriana officinalis) for insomnia is MOST accurate?

    <p>Continuous nightly use of valerian for days to weeks is needed for effects.</p> Signup and view all the answers

    What is the PRIMARY reason why 5-Hydroxytrytophan (5-HTP) is NOT recommended for the treatment of insomnia?

    <p>Its efficacy in treating insomnia is not established.</p> Signup and view all the answers

    Which of the following is the MOST accurate statement about the use of ethanol (alcohol) for the treatment of insomnia?

    <p>Ethanol initially improves sleep in patients who do not abuse alcohol, but high doses can lead to sleep disturbances.</p> Signup and view all the answers

    Which of the following statements about the use of chamomile, ginseng, lavender, hops, lemon balm, or passion flower for the treatment of insomnia is MOST accurate?

    <p>The evidence for the effectiveness of these herbal remedies in treating insomnia is inadequate, and they are not recommended for this purpose.</p> Signup and view all the answers

    What is the BEST evidence for the effectiveness of melatonin in treating insomnia?

    <p>Patients with neurological disorders</p> Signup and view all the answers

    What is the RECOMMENDED dosage range for melatonin in the treatment of insomnia?

    <p>0.3-5 mg</p> Signup and view all the answers

    What is the PRIMARY reason why 5-Hydroxytrytophan (5-HTP) is NOT recommended for the treatment of insomnia?

    <p>May be linked to eosinophilia-myalgia syndrome (EMS)</p> Signup and view all the answers

    What is the MOST accurate statement about the use of valerian (Valeriana officinalis) for insomnia?

    <p>Continuous nightly use of valerian for days or weeks is needed for effects.</p> Signup and view all the answers

    What is the RECOMMENDED approach for managing insomnia in pregnant women?

    <p>Weigh the benefits and risks of treatment on a case-by-case basis</p> Signup and view all the answers

    Which of the following complementary and alternative medicine (CAM) therapies has the STRONGEST evidence for improving sleep quality in patients with insomnia?

    <p>Melatonin</p> Signup and view all the answers

    What is the mechanism of action of diphenhydramine in treating insomnia?

    <p>Competes with histamine for H1-receptor sites</p> Signup and view all the answers

    Which of the following is a common side effect of diphenhydramine in the treatment of insomnia?

    <p>Dry mouth</p> Signup and view all the answers

    What is the primary benefit of using melatonin for treating insomnia?

    <p>Regulating sleep-wake cycles</p> Signup and view all the answers

    Which of the following is a key consideration when using complementary and alternative medicine (CAM) therapies for insomnia?

    <p>High risk of drug interactions</p> Signup and view all the answers

    What is the maximum duration recommended for the consecutive use of melatonin in treating insomnia?

    <p>~7-10 days</p> Signup and view all the answers

    Which of the following statements about pharmacologic treatment for insomnia is accurate?

    <p>Diphenhydramine is limited to symptomatic management of transient and short-term sleep difficulty</p> Signup and view all the answers

    Which of the following beverages contains the highest caffeine content per serving?

    <p>Extreme Lean</p> Signup and view all the answers

    What is the maximum recommended daily intake of caffeine for children?

    <p>2.5mg/kg/day</p> Signup and view all the answers

    Which of the following is a pregnancy category for caffeine according to the text?

    <p>Category B</p> Signup and view all the answers

    What is the known caffeine content in Coca-Cola per 12 oz serving?

    <p>34.5mg</p> Signup and view all the answers

    What is the caffeine content in a can of Red Bull?

    <p>80mg</p> Signup and view all the answers

    Which over-the-counter product contains the highest caffeine content according to the information provided?

    <p>NoDoz Maximum Strength</p> Signup and view all the answers

    Which of the following statements regarding melatonin use for insomnia is most accurate?

    <p>Melatonin treatment should be carefully timed to align with the patient's circadian rhythm.</p> Signup and view all the answers

    Which of the following complementary and alternative medicine (CAM) therapies has the strongest evidence for improving sleep quality in patients with insomnia?

    <p>Valerian</p> Signup and view all the answers

    A patient with insomnia is prescribed a low-dose melatonin supplement. Which of the following is the most important consideration when dosing melatonin for insomnia?

    <p>The timing of administration should align with the patient's circadian rhythm.</p> Signup and view all the answers

    Which of the following statements about the use of valerian (Valeriana officinalis) for insomnia is MOST accurate?

    <p>Valerian has the strongest evidence among CAM therapies for improving sleep quality in insomnia patients.</p> Signup and view all the answers

    Which of the following statements regarding the use of melatonin for insomnia is correct?

    <p>The timing of melatonin administration should align with the patient's circadian rhythm for optimal effectiveness.</p> Signup and view all the answers

    Which of the following statements about the use of valerian for insomnia is true?

    <p>Valerian has the strongest evidence among CAM therapies for improving sleep quality in insomnia patients.</p> Signup and view all the answers

    Which statement about the use of melatonin for insomnia is most accurate?

    <p>The timing and dosage of melatonin are crucial considerations for its use.</p> Signup and view all the answers

    Which of the following complementary and alternative medicine (CAM) therapies is likely to have the strongest evidence for improving sleep quality?

    <p>The text does not provide enough information to determine the most effective CAM therapy.</p> Signup and view all the answers

    Which of the following statements about the use of melatonin for insomnia is correct?

    <p>The timing of melatonin administration is an important consideration.</p> Signup and view all the answers

    Which of the following statements about the use of complementary and alternative medicine (CAM) therapies for insomnia is most accurate based on the information provided?

    <p>The text does not provide enough information to make definitive claims about the use of CAM therapies.</p> Signup and view all the answers

    Based on the information provided, which of the following statements about the use of melatonin for insomnia is correct?

    <p>The timing of melatonin administration is an important consideration.</p> Signup and view all the answers

    Which of the following statements about the use of complementary and alternative medicine (CAM) therapies for insomnia is most accurate based on the information provided?

    <p>The text does not provide enough information to make definitive claims about the use of CAM therapies.</p> Signup and view all the answers

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