Insomina, Sucide, and Ped Anxiety and Depression Flashcards Preview

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Flashcards in Insomina, Sucide, and Ped Anxiety and Depression Deck (87)
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1

What are the hypnotic drugs and their MOA

Ambien, Luensta, Sonata,

MOA: selective GABA stimulator

2

What are the Benzodiazepines that treat insomnia and their MOA

Restoril, Klonopin (long acting), Ativan (short acting)

MOA: Stimulate GABA receptor
*not as selective for sleep

3

What category of drug and MOA is Trazadone

Antidepressant

MOA: SSRI

4

What category of drug and MOA is Remeron

Antidepressant

MOA: SNRI

5

What category of drug and MOA is Seroquel

Atypical antipsychotic

antihistaminergic

6

What is the MOA of Rozerem

Melatonin receptor agonist-- stimulates the release of melatonin
-Involved in circadian rhythm

7

What is the MOA of Belsomra

Orexin receptor antagonist -- blocks orexin which promotes "wakefulness"

8

what insomina meds come in tablets that can easily be split?

Ambien, Lunesta, Trazaone,

9

What is the best use for Ambien and Ambien CR

Ambien: falling asleep (and often adequate for staying asleep 6-8 hrs)
*Be able to get 8ish hrs of sleep or still in the system
2. Works quickly (take when you are about to get in bed bc if you stay up if might experience side effects)

Ambien CR: Falling AND staying asleep longer (2nd burst after about 4 hrs)
-best if pt wakes too early w/ regular ambien

10

What is the best use for Lunesta

Falling AND staying asleep

*similar to Ambien

11

What is the best use for Sonata

1. Falling asleep (very short half-life so NO help w/ STAYING asleep)
2. good for PRN use (if person wakes during night some of the time)

12

What is the best use for Restoril

1. STAYING asleep
2. Can be good if anxiety is a significant component

13

What is the best use for Klonopin and Ativan

1. Insomina related to anxiety
2. High anxiety upon wakening--> Klonapin

14

What is the best use for Trazadone

1. Alternative to hypnotics and benzos
2. Can help SOME pts w/ sleep
3. Good alternative for someone w/ hx of addiction bc there is NO risk of tolerance/dependence

15

What is the best use for Remeron

1. Alternative to hypnotics and benzos
2. Good alternative for someone w/ hx of addiction bc there is NO risk of tolerance/dependence

16

What is the best use for Seroquel

1. Very good for sleep at LOW doses (not mood stabilizing dose)
2. Often works when other don't
3. Good alternative for someone w/ hx of addiction bc there is NO risk of tolerance/dependence

17

What is the best use for Rozerem

Effects very different from other sleep meds. Often not effective

18

What is the best use for Belsomra

-haven't seen much clinical benefit despite heavy marketing

19

Negatives of Ambien and Ambien CR

1. Can be in your system for 8 hrs
2. Memory loss
3. Slight risk of bizarre behavior (driving, sleeping walking, sleep eating)
4. habit forming??

Ambien CR: TOO long acting and above SE

20

Negatives of Lunesta

1. bad taste in mouth- metallicy
2. habit forming??

21

Negatives of Sonata

1. habit forming?

22

Negatives of Restoril

1. NOT as good for FALLING asleep
2. Must avoid ETOH
3. Watch for morning sedation**
4. Potential for tolerance/addiction

23

Negatives of Klonopin, Ativan

1. NOT as effective for sleep as the hypnotics
2. Must avoid ETOH
3. Potential for tolerance/addiction
4. Any of the usual benzo side effects

24

Negatives of Trazadone

1. Not as efficacious
2. Can cause daytime sedation
3. Priapism a rare but serious side effect (erection that won't go away)*

25

Negatives of Remeron

1. Sedation
2. weight gain**

26

Negatives of Seroquel

1. Weight gain
2. metabolic issues

27

Negatives of Rozerem

1. Not a controlled substance
2. Often not effective

28

Negatives of Belsomra

1. Next day sedation**
2. VERY expensive $10/pill
3. Clinically haven't seen much benefit-- be careful of overmarketing of the newest thing

29

What insomnia meds can cause weight gain

1. Remeron
2. Seroquel

30

What meds are best for FALLING asleep ONLY

1. Sonata