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CC: KL is a 79 yo man requesting assistance for “something to help with sleep”

PMH: Coronary artery disease and s/p CABG, hyperlipidemia, hypertension, major depressive disorder, and benign prostatic hypertrophy.

Current medications: Aspirin 81 mg daily, Lisinopril 20 mg daily, Metoprolol succinate 100 mg daily, Simvastatin 20 mg daily, fluoxetine 40 mg hs, and doxazosin 4 mg hs.

Substance Hx: He admits to drinking 2 alcoholic drinks/per night and denies smoking.

Include in your discussion:

· The differences in initial, middle, and terminal insomnia, and how would you best choose pharmacologic treatment for each one of these based on the half-lives of each hypnotic?

· Identify any secondary causes of insomnia.

· What treatment plan do you recommend for KL’s insomnia? (Be specific with your recommendations-which medication and why)

Discussion Rubric

· Posts are a minimum of 250 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and a minimum of 2 references (which may include the course textbook).

· The initial discussion post and discussion response should occur on two different calendar days of each electronic week.

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