Scottish Institute of Reflexology
Frequently Prescribed
Frequently Prescribed Medication for Sleep Problems
Benzodiazepines
A class of drugs with sedative, hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties, benzodiazepines are considered minor tranquilizers. Often used for short-term relief of severe, disabling anxiety or insomnia. The development of tolerance and physiological and psychological dependency can cause problems with long-term use. They are believed to act on the GABA receptor GABAA, the activation of which dampens higher neuronal activity.
Short-acting - work for less than six hours and have few residual effects if taken before bedtime, but rebound insomnia may occur and they can cause wake-time anxiety. Intermediate-acting - act for between 6-10 hours. They may have mild residual effects but rebound insomnia is un-common.
Long-acting – give strong sedative effects that persist, but accumulation of the compounds in the body may occur.
Brand names of common benzodiazepines used for insomnia: Gerodorm, Valium, Apzepam, Stesolid, Apozepam, Hexalid, Valaxona, Rohypnol, Fluscand, Flunipam, Ronal, ProSom, Dalmane, Dormonoct, Noctamid, Pronoctan, Dormicum, Versed, Hypnovel, Mogadon, Apodorm, Pacisyn, Dumolid, Doral, Restoril, Normison, Euhypnos, Halcion, Rilamir.
Benzodiazepines have replaced barbiturates because they have a lower abuse potential and relatively lower adverse reactions and interactions. Still, drowsiness, ataxia, confusion, vertigo, impaired judgement, and a number of other effects are common. Impairment in the ability to drive vehicles and to operate machinery may be caused by the side effects of benzodiazepines. The impairment is worsened by consumption of alcohol, because both act as central nervous system depressants. In fact, consuming any benzodiazepine with alcohol can result in a potentially fatal overdose. As the effects of long-acting benzodiazepines can carry over to the next day, people taking these must be aware and take necessary care the following day as well.
Tolerance to the hypnotic and sedative effects of benzodiazepines develops within days with daily or frequent use.
Every person on long-term or high dosage of any benzodiazepine should be slowly and carefully weaned, very gradually tapering off the drug over a period of many weeks or even months.
Facts from Wikipedia, the free encyclopaedia online.
Louise Baillie MSIR
Frequently Prescribed Medication for Kidney Problems
Phosphate binders
Virtually all the substances in the blood can be regulated by dialysis. The exception is phosphates which can build up and combine with calcium in the blood. This mixture can cause damage by being deposited on the blood vessel walls, cause itchiness and affect the strength of the bones and joints.
As they are present in most foods, phosphate levels are difficult to control through diet. Renal patients will be given advice on how to lower their phosphate intake through diet, but drugs called phosphate binders are likely to be prescribed. These prevent the absorption of phosphates into the bloodstream and are usually calcium carbonate (chalk) tablets, or other calcium salts such as calcium acetate. Sometimes, aluminium hydroxide gel or capsules are prescribed to bind phosphates. However, aluminium can have toxic effects if used on a long-term basis.
Antihypertensives (blood pressure pills)
The majority of renal patients will be on one or a combination of several antihypertensives to reduce blood pressure. These aim to relieve the symptoms of breathlessness and also prolong the functioning of the kidneys. Some examples of antihypertensive drugs are: Calcium antagonists (their names end in '-pine'); ACE inhibitors (their names end in '-pril'); ATI antagonists (their names end in '-artan'); Beta blockers (their names end in '-olol').
Diuretics (water tablets)
Diuretics tablet remove fluid by increasing the amount of urine that is passed. Examples of diuretics are Frusemide and Bumetanide.
EOP
Not everyone needs EPO (Erythropoietin), however in some cases of kidney failure the body cannot make its own and this leads to anaemia. EPO is one of the hormones that stimulate the bone marrow to make blood cells. It is often prescribed, at first to correct anaemia, and occasionally at a lower dose, on an ongoing basis, to keep the red blood cell count up.
Iron and vitamins
Water soluble vitamins such as B and C can be lost during dialysis and damaged kidneys are unable to convert vitamin D for use. An active form of vitamin D (alpha calcidol), vitamins B and C, and iron tablets (see EOP) are prescribed to most renal patients.
Laxatives
Because their fluid intake is restricted, constipation can be a problem for dialysis patients. They require a prescription from their renal unit as not all laxatives are suitable for renal patients.