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Titolo:
Treatment of insomnia in hospitalized patients
Autore:
Lenhart, SE; Buysse, DJ;
Indirizzi:
Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15213 USA Univ Pittsburgh Pittsburgh PA USA 15213 erapeut, Pittsburgh, PA 15213 USA Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15213 USA Univ Pittsburgh Pittsburgh PA USA 15213 sychiat, Pittsburgh, PA 15213 USA
Titolo Testata:
ANNALS OF PHARMACOTHERAPY
fascicolo: 11, volume: 35, anno: 2001,
pagine: 1449 - 1457
SICI:
1060-0280(200111)35:11<1449:TOIIHP>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
PHARMACOLOGICAL TREATMENT; ZOLPIDEM; SLEEP; TRAZODONE; ZALEPLON; EFFICACY; ABUSE; MANAGEMENT; TRIAZOLAM; BENZODIAZEPINES;
Keywords:
benzodiazepines; insomnia; trazodone; zaleplon; zolpidem;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
66
Recensione:
Indirizzi per estratti:
Indirizzo: Lenhart, SE Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, 200 Lothrop St,302 Scaife Hall, Pittsburgh, PA 15213 USA Univ Pittsburgh 200 Lothrop St,302 Scaife Hall Pittsburgh PA USA 15213
Citazione:
S.E. Lenhart e D.J. Buysse, "Treatment of insomnia in hospitalized patients", ANN PHARMAC, 35(11), 2001, pp. 1449-1457

Abstract

OBJECTIVE: To provide recommendations for the short-term management of insomnia in hospitalized patients and review patient assessment, nonpharmacologic treatment modalities, and selection of hypnotic medications. DATA SOURCES: Review articles and primary literature representative of current knowledge regarding the treatment of insomnia were identified by MEDLINE search (1966-January 2001). Search items included insomnia (sleep initiation and maintenance disorders), benzodiazepines, zaleplon, zolpidem, and trazodone. DATA SYNTHESIS: Literature regarding the management of insomnia in hospitalized patients is limited; therefore, data pertinent to the treatment of ambulatory patients must be extrapolated to the inpatient setting. When evaluating insomnia in hospitalized patients, it seems reasonable to obtain a thorough history and physical examination to identify potential underlying etiologies. Treatment of these underlying etiologies should be considered. When the use of a sedative-hypnotic agent is necessary, medication and dose selection should be based on the pharmacokinetic and adverse effect profilesof each agent. Patient-specific characteristics should also be considered to provide effective treatment while minimizing adverse effects. CONCLUSIONS: Nonpharmacologic approaches to the treatment of insomnia should be considered for hospitalized patients. When sedative-hypnotic medications must be administered, the pharmacokinetic profile of intermediate-acting benzodiazepines (e.g., lorazepam, temazepam) makes them good first-line agents. Zaleplon and zolpidem are also attractive hypnotic agents; however, they are typically reserved for second-line therapy due to cost. Trazodone may be an alternative for patients unable to take benzodiazepines.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 22:35:58