Insomnia

Question 1

MOA: orexin receptor antagonist

Answer 1

Suvorexant

Question 2

Suvorexant is a ___

Answer 2

3A4 substrate - lower the dose if given with inhibitors

Question 3

suvorexant is a ___ controlled substance

Answer 3

CN 4

Question 4

first tx for non 24 hour sleep wake disorder(biind pts)

Answer 4

tasimelteon

Question 5

ADR of tasimelteon

Answer 5

increased LFT, URI, UTI, weird dreams/ nightmares, somnolence

Question 6

DI of tasimelteon

Answer 6

CYP1A2 inihibitors (amiodarone, efavirenze, fluroquinolone)

CYP3A4 inducers (carbamazepine, efavirenz, phenobarbital, rifampin, st john wart etc)

Question 7

Tasimelteon had ___ in animal studies

Answer 7

fetal harm

Question 8

suvorexant ADR

Answer 8

next day impairment, depression, hallucinations, sleep paralysis, decreased resp function

Question 9

ramelteon is a ___

Answer 9

CYP1A2 drug

Question 10

directions for ramelteon

Answer 10

take on empty stomach within 30 min go to bed

Question 11

melatonin receptor agonist drugs

Answer 11

ramelteon and tasimelteon

Question 12

_____ melatonin receptor agonist is not recommeneded with hepatic impairment

Answer 12

tasimelteon

Question 13

zaleplon MOA

Answer 13

BZD receptor agonist

Question 14

zaleplon “niche” property

Answer 14

can take if wake up in middle night if have 4 hrs left to sleep

Question 15

zaleplon brand

Answer 15

sonata

Question 16

zolpidem is used for..

Answer 16

sleep onset and maintenance impairment

Question 17

___ BZD receptor agonist must start with lower dose for women

Answer 17

Zolpidem

Question 18

brand zolpidem

Answer 18

ambien

Question 19

main concerning adr of zolpidem

Answer 19

Parasomnias: sleep eat and drive

next day impairment

Question 20

zolpidem interacts with&raquo_space;>

Answer 20

? but its a 3A4 substrate

Question 21

pregnancy and CS ranking of zolpidem

Answer 21

preg C and C4

Question 22

indication esozopiclone

Answer 22

sleep onset and maintanence

Question 23

esozopiclone vs zolpidem

Answer 23

esozopiclone has longer half life and is dose dependent

Question 24

main esozopiclone adrs

Answer 24

bad taste, next day impairment

Question 25

esozopiclone is a

Answer 25

3A4 substrate

Question 26

esozopiclone interacts with

Answer 26

CNS depressants like alcohol

Question 27

temazepam is a __ used for ___

Answer 27

BZD for short term insomnia up to 2 wks

Question 28

triazolam is a __ used for __

Answer 28

BZD for pre op anxiety, its amnestic

Question 29

MOA of BZD receptor agonists

Answer 29

bind to GABA receptor at BZD one site

Question 30

benefits of BZD receptor agonist

Answer 30

targeted sedation, less anxiolysis, anticonvulsant effects, lower dependence risk

Question 31

insomnia definition

Answer 31

dissatisified with sleep quality or quantitiy

Question 32

Dx criteria

Answer 32

causes impairment 3+ nights per wk for 3 mo no other linked disorder

Question 33

historical sleep aid

Answer 33

thalidomide: for morning sickness, leading to flipper baby arms/ legs

Question 34

meds for sleep latency

Answer 34

ZZERTT ``` Zaleplon Zolpidem Eszopiclone Ramelteon Triazolam ```

Question 35

sleep maintance meds

Answer 35

``` TEDZS Temazepam Esozopiccone Doxepin Zolpidem Suvorextant ```

Question 36

use of hypnotics (BZD and their receptor agonists ) can..

Answer 36

have increased risk dementia, fractures, major injury, cognitive impairment - driving risk