Zolpidem: Efficacy and Side Effects for Insomnia.

Purpose Of Review: Insomnia is a common type of sleep disorder defined by an ongoing difficulty initiating or maintaining sleep or nonrestorative sleep with subsequent daytime impairment. The sleep disturbances in insomnia usually manifest as difficulty in falling asleep, maintaining the continuity of sleep, or waking up too early in the morning well before the desired time, irrespective of the adequate circumstances to sleep every night. Insomnia can significantly impact daytime functioning resulting in decreased workplace productivity, proneness to errors and accidents, inability to concentrate, frequent daytime naps, and poor quality of life.

Tacrolimus (FK506) in the treatment of severe, refractory rheumatoid arthritis: initial experience in 12 patients.

Objective: To determine if tacrolimus (FK506) has potential as a therapeutic agent in patients with severe and/or refractory rheumatoid arthritis (RA).

Methods: Twelve patients with RA who had severe and active disease and had failed an average of 5.3 disease modifying antirheumatic drugs (DMARD) were treated with tacrolimus 2-6 mg/day in an open label study.

Fibromyalgia: recognizing and treating an elusive syndrome.

The noninflammatory, diffuse pain syndrome recognized as fibromyalgia primarily affects women between puberty and menopause. Symptoms, in addition to musculoskeletal pain and tender points, can include fatigue, nonrestorative sleep, and depression. A precipitating event such as abrupt cessation of exercise, physical injury, or prior debilitating illness can often be identified.

Rheumatoid arthritis. Designing and implementing a treatment plan.

Treating rheumatoid arthritis can be very satisfying when patients participate fully in designing and implementing their therapeutic strategy. However, the strategy's success depends on early intervention and disease modification. Many patients do well when education, rest, diet, exercise, and drug therapy are incorporated into an individualized regimen.