Introduction . Although not definite, studies are finding Alzheimer's disease may be related to loss of cholinergic innervation. In order to impact this loss of function, therapeutic agents have been developed to reduce the breakdown of acetylcholine, a neurotransmitter vital in cognitive processes. Donepezil has been used in Alzheimer's disease for improving cognition. Although the package insert suggests nighttime administration to reduce the instance of daytime side effects, some patients report sleep disturbances. Methods . Patient charts at the Tallahassee Memorial Healthcare Neuroscience Center (TMH-NSC) were reviewed. Charts of those patients who met the inclusion criteria were used to determine the correlation between night time administration of donepezil and sleep disturbances. Results . A total of 186 patient charts were analyzed. Of those 186, 103 of the patients were taking donepezil as directed in the package labeling, at night time. Nearly half (47.6%) of the patients taking donepezil at night reported night time disturbances (NTD) and only 21 of the 83 patients taking donepezil in the morning reported NTD. Conclusion . This retrospective study showed that taking donepezil at night may be associated with sleep disturbances. Although labeling suggests administration in the evening, should NTDs occur, changing the medication administration to the morning should be explored before switching therapeutic agents.

Systemic lupus erythematosus (SLE) is an autoimmune disease that affecting at least 1.5 million Americans. The exact cause of SLE is unknown; however there are numerous factors that are thought to play a role in the development of SLE. While there are several medications available for the management of SLE, Belimumab is the first medication approved for SLE management in over 50 years. Researchers are investigating other medications that may provide some benefit in SLE management and improve patient outcomes. These emerging treatments explore other mechanisms for management and targeting symptoms. SLE has a higher mortality rate than other rheumatic diseases and new and continuous research is needed with the aim to decrease the number of deaths and improve patients' quality of life. Key wordsSLE, Autoimmune, Lupus, Pharmacotherapy, Interferon BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease that has the potential to affect every organ in the body; however the disease affects most commonly the skin, kidneys, brain, and joints. According to the Lupus Foundation of America, at least 1.5 million Americans have SLE, although the actual number may be higher; there have been no large-scale studies to solidify the exact number of individuals living with SLE in the U.S. Annually, there are more than 16,000 new cases of SLE reported across the country. Women of childbearing age are considered the population mostly affected by Lupus. Although people of all races and ethnic groups can develop lupus, African-American women are 2-3 times more likely to develop SLE than any other population. Over the years, the life expectancy of such patients has improved from an approximate 4-year survival rate of 50% in the 1950s to a 15 year survival rate of 80% today. The leading cause of death in patients with SLE is kidney failure; however other causes include infections, cerebrovascular disease, cardiovascular disease, and cancer [1] .The exact cause of SLE is not known, however environmental, genetic, and hormonal factors are all thought to possibly lead to the development and expression of SLE. Current data illustrates the risk for development of SLE in siblings of individuals with the disease is about 20 times higher than that of the general population. The rate of identical twins