a patient of age 65 years , who is obesity of bmi >40 , known diabetic and hypeensive .patient complaints of breathlessness , excessive sleeping during morning time with headache and with mood swings, what is drug that helps in resolving the symptoms ?
High-Yield Explanation
OSA-obstructive sleep apnea #Pathophysiology of OSA Tissue laxity and redundant mucosa Normal Anatomic abnormalities * Decreased muscle tone with REM sleep """&;"&;n * Airway collars, * Desaturation ( 02 ) * Arousal with restoration of airway * Sleep Fragmentation leading to Hypersomnoien, * Clinical features of Obstructive Sleep Apnea: #Excessive daytime sleepiness #Morning headache #Cardiopulmonary dysfunction -- hypeension -- cardiac arrhythmias -- hea failure #Impaired memory and concentration #Reduced intellectual ability #Disturbed personality and mood . *The dominant symptoms of OSA are excessive sleepiness, impaired concentration and snoring. Pharmacologic therapy * Modafinil is approved by the US Food and Drug Administration (FDA) for use in patients who have residual daytime sleepiness despite optimal use of CRAP. * Selective serotonin reuptake inhibitor agents such as paroxetine (Paxil) and fluoxetine (Prozac) have been shownto increase genioglossal muscle activity and decrease REM sleep (apneas are more common in REM), although this has not translated to a reduction in AHI in apnea patients ref : kd tripathi 8th ed