Term
| Diphenhydramine and Doxylamine (may/may not) be used for long term use |
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Definition
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Term
| Diphenhydramine and Doxylamine are used for _____ insomnia (ie, what degree of insomnia?) |
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Definition
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Term
| T/F: If not proving effective, increasing doses of Diphenhydramine or Doxylamine may help to increase sedation. |
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Definition
| False. Only increases SEs. |
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Term
| What effect to Doxylamine and Diphenhydramine have on REM sleep? |
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Definition
| REM sleep is suppressed; REM rebound may occur |
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Term
| Which is the most popular alternative med for insomnia? What are the other options, and why aren't they recommended? |
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Definition
| Melatonin. Kava Kava and Valerian root, due to liver problems. |
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Term
| What drug(s)s has/have and MoA of competing with histamine for H1 sites, as well as having anticholinergic effects? |
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Definition
| Doxylamine and Diphenhydramine |
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Term
| With chronic use (1-2 weeks) the effects of Doxylamine and Diphenhydramine _______ |
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Definition
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Term
| Melatonin is usually used for _____ and can be used to regulate______ |
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Definition
| jet lag; circadian rhythm |
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Term
| Which drug(s) has/have an MoA of blocking 5HT2, and as such is an/are antidepressant(s)? |
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Definition
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Term
| Trazodone should avoid doses above 200 mg because______ |
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Definition
| it is activating above 200 mg |
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Term
| Mirtazapine, at higher doses, can _____ |
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Definition
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Term
| With SSRI-treated patients, which drug(s) has/have the best documentation? |
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Definition
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Term
| What are the TCAs used in insomnia? |
|
Definition
AD:
Amitriptyline and Doxepin |
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Term
| Which drug(s) can cause cardiovascular toxicity and can be fatal if OD'd? |
|
Definition
| Amitriptyline and Doxepin |
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Term
| Orthostatic hypotension, urinary hesitancy, dry mouth, blurred vision, dizziness, constipation and cognitive effects in the elderly are SEs of what drug(s)? |
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Definition
| TCA's: Doxepin & Amitriptyline |
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Term
| With sleep, the BZDs function by______ |
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Definition
| reducing latency and increasing total sleep time |
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Term
| The BZDs affect the sleep cycle by____ |
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Definition
| increasing stage 2 and reducing 3, 4, and REM |
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Term
| Which patients should avoid BZDs? |
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Definition
| those with apnea, pregnancy, history of substance abuse and alcohol use |
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Term
| paraodoxical reactions may be seen in what class of drug and with what drug specifically? |
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Definition
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Term
| With the BZDs, rebound may be seen with ______ |
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Definition
|
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Term
| anterograde amnesia may occur with _____ |
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Definition
| rapid onset BZDs, eg lorazepam |
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Term
| Seizures may result with abrupt discontinuation with which drug(s)? |
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Definition
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Term
| _______ increase the risk of hip fractures in the elderly |
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Definition
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Term
| _______ have increased risk of motor vehicle and pedestrian accident rates |
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Definition
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Term
| The BZDs approved for Insomnia are ______ |
|
Definition
QuEFTT:
Quazepam, Estalzolam, Flurazepam, Triazolam and Temazepam |
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Term
| Triazolam is used for ______ in insomnia |
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Definition
|
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Term
| The most common BZDs used are _____ due to _____ |
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Definition
| Triazolam and temazepam; shorter half life |
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Term
| Which drug(s) has/have an MoA of Omega 1 alpha 1 subunit selectivity of the GABA-A complex? |
|
Definition
| The Z drugs (Zolpidem, Zaleplon, Eszopiclone) |
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Term
| Which drug(s) preserve(s) the sleep stages, and has/have low incidence of tolerance and rebound insomnia? |
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Definition
|
|
Term
| Zolpidem's dosing should be halved in what patients? |
|
Definition
| elderly and hepatically impaired |
|
|
Term
| Which Z drug should only be used for one month? |
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Definition
|
|
Term
| Which Z drug has no active metabolites? |
|
Definition
|
|
Term
| Which Z drugs is/are used to initiate and maintain sleep, and which is/are used to initiate sleep? |
|
Definition
I&M: Zolpidem and Eszpoiclone
Initiate:Zaleplon |
|
|
Term
| Which Z drug has a CR formulation? |
|
Definition
|
|
Term
| Zaleplon's dosing should be adjusted/halved in _____ |
|
Definition
| the hepatically impaired/elderly |
|
|
Term
| What Z drug may be taken in the middle of the night? |
|
Definition
| Zalaplon. 4 hours must remain. |
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|
Term
| Which Z drug is least likely to cause next day sedation? |
|
Definition
|
|
Term
| Zaleplon is (rapid/slow) onset and (short/long) duration. Additionally, it causes (No/Mild/Moderate/Severe) psychomotor and memory impairment. |
|
Definition
|
|
Term
| Eszopiclone should be halved in what cases? |
|
Definition
| elderly, severe hepatic impairment, or with potent 3A4 inhibitors. |
|
|
Term
| What Z drug is more like a BZD as i has mild anxiolytic, muscle relaxant and anticonvulsant effects? |
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Definition
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|
Term
| Unpleasant taste is an SE for which Z drug(s)? |
|
Definition
|
|
Term
| What drug(s) has/have and MoA of being a Melatonin receptor agonist, MT1 and MT2 selective over MT3, with no GABA affinity? |
|
Definition
|
|
Term
| Which receptors are though to help regulate circadian rhythm and sleep onset, which helps sleep and changes sleep architecture? |
|
Definition
|
|
Term
| Ramelteon (has/has no) evidence of abuse or dependence. |
|
Definition
|
|
Term
| SEs of Fatigue, dizziness, drowsiness and AEs of HA, dizziness and somnolence can be attributed to ______ |
|
Definition
|
|
Term
| In narcolepsy, the class of drugs used for sleep attacks include ______, which are/is _______ |
|
Definition
| psychostimulants, MoDeM: Modanfinil, Dextroamphetamine, Methylphenidate |
|
|
Term
| Cataplexy ADJUNCTS, include _______ |
|
Definition
| TCAs (Nortriptyline, Clomipramine, Imipramine -- NorClIm) and SSRIs |
|
|
Term
| The only FDA approved cataplexy agent is ________, which is a form of _______. It is also used for _______ |
|
Definition
| Sodium Oxybate; GHB; sleep attacks |
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|
Term
| What drug(s) is/are first line for Restless Leg Syndrome? |
|
Definition
| Dopamine Agonists: Ropinirole and Pramipexole, in doses LOWER than that used in Parkinson's |
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|
Term
| _______ should be given if Restless Leg Syndrome causes frequent awakenings. |
|
Definition
|
|
Term
| _______ should be given if Restless Leg Syndrome causes frequent awakenings. |
|
Definition
|
|
Term
| ______should be given if Restless Leg Syndrome proves painful. |
|
Definition
| GOCoM: Gabapentin, Oxycodone, Codeine or Methadone |
|
|
Term
| If needed, what sort of supplement should be given in Restless Leg Syndrome? |
|
Definition
|
|
Term
| (pharmacologic/nonpharmacologic) treatment is preferred for treating Obstructive Sleep Apnea. ______is the first line treatment. |
|
Definition
| nonpharmacologic; CPAP machine |
|
|
Term
| CNS depressants should be (1st line pharmacologic/avoided) in treating Obstructive sleep apnea, because______ |
|
Definition
| avoided, because it will reduce the gasping reflex when the PT attempts to breathe |
|
|
Term
______ is used for mild apnea w/o hypercapnea.
______ helps to reduce apnea in some PTs. |
|
Definition
| Protriptyline; Fluoxetine |
|
|
Term
| Which hypnotic agents are less popular? |
|
Definition
| Chloral Hydrate and Barbiturates |
|
|
Term
| This drug Causes memory loss, lots of GI irrigation, and is 3x more potent than alcohol |
|
Definition
|
|
Term
| Which hypnotic(s) can cause rapid tolerance, has withdrawal symptoms, many interactions, may cause dependence and has many withdrawal symptoms? |
|
Definition
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