A patient reports frequent sleep disturbances. Which preparations ...

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A patient reports frequent sleep disturbances. Which preparations could be considered to help improve the patient's sleep pattern? Select all that apply.
 
  a. Yohimbine
  b. Vitamin C
  c. Melatonin
  d. Valerian
  e. SAM-e

Question 2

Priority assessments for a patient beginning amitriptyline (Elavil) include
 
  a. nausea, diarrhea, and irritability.
  b. seizures, agranulocytosis, and insomnia.
  c. headache, sexual dysfunction, and weight loss.
  d. history of falls, arrhythmias, and blurred vision.

[sokh]

Answer to Question 1

C, D
Melatonin and valerian have relaxant effects that help sleep. Yohimbine can actually cause insomnia. SAM-e may help with mild depression. Vitamin C has no effect on sleep.

Answer to Question 2

D
Tricyclic antidepressants (TCAs) produce anticholinergic (blurred vision) and antiadrenergic (orthostatic hypotension leading to falls and arrhythmias) side effects. Gastrointestinal symptoms, sexual dysfunction, and weight variations are related to selective serotonin reuptake inhibitor (SSRI) therapy. Seizures are seen with bupropion therapy. Agranulocytosis is not considered a major problem with any of the groups of antidepressants.