Failure to limit quantities of benzodiazepine hypnotic drugs for outpatients: placing the elderly at risk
Article Abstract:
Sedative hypnotics, particularly benzodiazepines, are widely used in the United States to induce sleep. However, the long-term use of hypnotic agents does not maintain improvements in sleep, and may contribute to the increased incidence of falls, hip fractures, daytime sedation, and impaired intellectual function in the elderly. Hence, prolonged use of hypnotics is not advised, and prescription of limited quantities with frequent re-evaluation of hypnotic use is recommended. Although studies have shown an increased incidence of insomnia and hypnotic use with increasing age, there is limited knowledge about the relationship between prescriptions for hypnotics and the patient's age. Hence, the relationship between patient age and total number of doses of hypnotics prescribed at a single physician visit was assessed. The pharmacy and patient records for 655 prescriptions of the hypnotic drugs triazolam (Halcion) and flurazepam (Dalmane) were analyzed. The results showed that 266 prescriptions were for 30 or fewer doses, whereas 178 prescriptions were written for 180 or more doses. Of prescriptions for 180 or more doses of hypnotics, 36 percent were for patients aged 65 years and older, 24 percent were for patients aged 45 to 64 years, and 16 percent were for patients less than 45 years old. Further statistical analysis showed that patients aged at least 65 were more likely than younger patients to receive prescriptions for hypnotics for 180 or more doses. Thus, elderly patients were most likely to receive inappropriately large amounts of benzodiazepine hypnotics. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Benzodiazepines, breathing, and sleep
Article Abstract:
The prevalence of sleep apnea, or cessation of breathing during sleep, in men aged 65 years and younger ranges from 1.5 to 5 percent. This sleep disorder also affects many postmenopausal women over age 50 years. One study showed that the apnea index, or number of apnea events per hour of sleep, was associated with decreased longevity in elderly women. Apnea has been associated with various sleep-related problems such as daytime tiredness, fatigue, and insomnia or inability to sleep at night. The benzodiazepines are sedative hypnotic agents used to treat insomnia; they work by depressing the central nervous system. These drugs may worsen sleep-related breathing disorders, particularly in patients with lung disease or heart failure. Benzodiazepines are most commonly used to treat insomnia in elderly patients with multiple medical problems. The long-term use of these agents may be associated with the development of apnea in heavy snorers and in patients who recently had a heart attack. Since various types of benzodiazepines differ in their hypnotic action, the effects of a given benzodiazepine on vital signs during sleep should be tested. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Sleep apnea syndrome in chronic renal disease
Article Abstract:
This paper examined sleep apnea (temporary attacks of respiratory failure during sleep where a patient stops breathing for 10 or more seconds) in patients with an advanced stage of severe kidney disease and who were being treated with kidney dialysis. In a sleep laboratory, the authors evaluated 26 patients suffering from end
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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