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Chapter22
Restless Leg Syndrome
13
Medical
Professional
09/30/2011

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Term
Non-pharm options for RLS
Definition
Mental alertness activities

Abstinence from alcohol, caffiene, or nicotine

Hot baths, stretching, moderate exercise

D/C meds that contribute to symptoms including antidepressants, antipsychotics, dopamine-blocking anti-emetic, sedating antihistamines
Term
If RLS is due to low iron levels what can be done?
Definition
Iron supplementation
Term
Intermittent RLS
Definition
RLS, but not troublesome enough or frequent enough to require daily therapy
Term
Daily RLS
Definition
RLS, troublesome enough or frequent enough to require daily therapy
Term
DOC(s) for Daily RLS?
Definition
Dopamine Agonists: Bromocriptine, pergolide, pramipexole, ropinirole
Term
What are dopamine agonists associated with?
Definition
Pathological gambling and hypersexuality
Term
Levodopa/Carbidopa, place in therapy RLS?
Definition
Intermittent RLS only, NOT daily RLS, because of short half-life and potential for rebound and augmentation
Term
Gabapentin place in therapy for RLS?

Major side effect of Gabapentin ?
Definition
DOC for Daily RLS WITH PAIN.

Major Side effect of Gabapentin - Drowziness & unsteady gait
Term
Opioids, place in therapy for RLS?
low potency?
higher potency?
Definition
Opioids are second line options for RLS, both intermittent and daily

Low potency eg. Codeine --> Intermittent

Higher potency eg. oxycodone or methadone --> Daily RLS
Term
BDZs place in therapy?
Definition
Adjuctive therapy in all RLS to improve quality of sleep. Can be first line with other RLS meds.
Term
RLS choices during pregnancy ?
Definition
None of the drugs used are known to be safe in pregnancy.

Opioids can be used, but be careful and monitor for respiratory depression when approaching birth.
Term
When should these drugs be given?
Definition
1-2 hours before bedtime
Term
What is most likely to cause rebound RLS?
Definition
Carbidopa/levodopa
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