Role of pharmacists in the treatment of excessive daytime sleepiness.

The focus of this case is a 78-year-old female who is being referred to an assisted living community following several episodes of excessive daytime sleepiness (EDS). EDS in the geriatric patient is widespread and is often underdiagnosed and inadequately treated. It can affect an older patient?s quality of life, as well as increasing physical, psychological, cognitive, and mortality risks. There are many different etiologies for EDS including coexisting medical conditions, circadian misalignment, medications affecting the sleep/wake cycle, and psychiatric or psychosocial circumstances. This case illustrates how the pharmacist can help patients with EDS by recognizing symptoms; performing a targeted medical history, sleep history, and medication review; and offering screening with validated tools to refer patients to sleep specialists. There are both pharmacological and nonpharmacological treatment options. The consultant pharmacist is a vital member of the interprofessional health care team and can play a major role in the education, monitoring, and management of EDS.

Sodium oxybate: a primer for pharmacists in the treatment of narcolepsy.

OBJECTIVE: The purpose of this report is to describe a 57-year-old man who was admitted to a nursing facility for physical therapy. His home medication list included sodium oxybate. This article will provide the pharmacist with a therapeutic overview of sodium oxybate as well as review the unique processes involved with drug acquisition, dosing, patient education, and monitoring. SETTING: Community pharmacy, nursing facility pharmacy, consultant pharmacy practice. PRACTICE CONSIDERATIONS: Sodium oxybate is the only medication in the United States that has approval for both treatment of cataplexy in narcolepsy and treatment of excessive daytime sleepiness in narcolepsy. Sodium oxybate has many unique properties that cause it to differ from past therapies for cataplexy and excessive daytime sleepiness associated with narcolepsy. CONCLUSION: It is important for pharmacists to understand the therapeutic uses of sodium oxybate and to review the processes for acquisition, dosing, and administration to better assist physicians and patients and improve therapeutic outcomes.