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PHRM 845 > L? Sleep disorders Ott > Flashcards

L? Sleep disorders Ott Flashcards

(64 cards)

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1
Q

diagnostic criteria of insomnia:
how often?
how long?

A

at least 3 nights per week for 3 months

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2
Q

what is the only benzo that ott says is used even though they all “can be”

A

temazepam

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3
Q

first line tx of insomnia disorders

A

sleep hygiene principles

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4
Q

Most commonly used sleep meds?

A

z-hypnotics
(zolpidem, eszopiclone, zaleplon)

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5
Q

What is the initial dose of zolpidem in women and elderly?

A

5 mg (lower)

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6
Q

which z-hypno is FDA approved for long term use

A

eszopiclone

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7
Q

which z-hypno leaves pts complaining of metallic taste

A

eszopiclone

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8
Q

T or F: all 3 z-hypnos are CYP2D6 substrates

A

false, 3A4

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9
Q

4 side effects of z-hypnos

A

somnolence
dizziness
ataxia
headaches

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10
Q

what is a warning on all z-hypnos?

A

parasomnias - unusual actions while someone is sleeping

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11
Q

T or F: All but 1 of the z-hypnos is a control

A

false, they all are

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12
Q

Contraindicated with fluvoxamine
A. Ramelteon
B. Tasimelteon

A

A. Ramelteon

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13
Q

GI upset, next day somnolence, hyperprolactinemia, prolactinemia
A. Ramelteon
B. Tasimelteon

A

A. Ramelteon

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14
Q

FDA approved for non-24 sleep-wake disorder in adults
A. Ramelteon
B. Tasimelteon

A

B. Tasimelteon

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15
Q

1A2 substrate: watch for 1A2 inducers and inhibitors
A. Ramelteon
B. Tasimelteon

A

both

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16
Q

what do the 3 orexin receptor antagonists end with

A
  • orexant
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17
Q

aim for at least 7 hours of sleep after taking
A. Suvorexant
B. Lemborexant
C. Daridorexant

A

all

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18
Q

contraindicated in narcolepsy bc of narcolepsy-like side effects
A. Suvorexant
B. Lemborexant
C. Daridorexant

A

all

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19
Q

3A4 substrate
A. Suvorexant
B. Lemborexant
C. Daridorexant

A

all

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20
Q

TCA - low doses exert effects through H1 antagonism
A. Doxepin
B. Trazodone

A

A. Doxepin

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21
Q

Anticholinergic side effects
A. Doxepin
B. Trazodone

A

A. Doxepin

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22
Q

Not FDA-approved for insomnia
A. Doxepin
B. Trazodone

A

B. Trazodone

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23
Q

Long half-life, may see daytime hangover
A. Doxepin
B. Trazodone

A

B. Trazodone

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24
Q

used as sleep agent especially in pts w/ depression
A. Mirtazapine
B. Quetiapine

A

A. Mirtazapine

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25
low dose not recommended in insomnia unless there is a co-morbid psych disorder A. Mirtazapine B. Quetiapine
B. Quetiapine
26
Not recommended by AASM A. bendaryl/doxylamine B. Melatonin C. Valerian D. Chamomile
A
27
Anticholinergic side effects A. bendaryl/doxylamine B. Melatonin C. Valerian D. Chamomile
A
28
Can be considered in jet lag A. bendaryl/doxylamine B. Melatonin C. Valerian D. Chamomile
B
29
1A2 substrate A. bendaryl/doxylamine B. Melatonin C. Valerian D. Chamomile
B
30
contains a BZD-like compound A. bendaryl/doxylamine B. Melatonin C. Valerian D. Chamomile
D
31
allergic reactions in pts w/ daisy or ragweed allergies A. bendaryl/doxylamine B. Melatonin C. Valerian D. Chamomile
D
32
AASM 1st line therapy
CBT and behavioral therapies
33
diagnostic criteria of obstructive sleep apnea
at least 5 obstructive apneas per hour of sleep confirmed by polysomnography
34
T or F: clinically, there is greater recognition that many pts have apnea and insomnia
true
35
T or F: if a pt has apnea and insomnia, treat insomnia first
false, apnea first
36
at least 1 of 6 things needs to be present for use of a polysomnography in obstructive sleep apnea, what are they?
- cardiorespiratory disease - muscle weakness due to neuro-muscular condition - sleep-related hypoventilation - chronic opioid use - stroke - severe insomnia
37
What is the first non-pharm option you should consider in the tx of sleep apnea?
weight loss
38
T or F: Sleeping on stomach rather than back will help sleep apneas
False, sleep on side
39
what tf is CPAP?
continuous positive airway pressure
40
what two drugs can treat excessive daytime sleepiness in sleep apnea (maybe others too idk)
modafinil and armodafinil
41
what 3 things are included in the narcolepsy triad?
EDS hallucinations Sleep paralysis
42
100% of pts A. EDS B. Cataplexy C. Hallucinations D. Sleep paralysis E. All four sxs
A
43
75% of pts A. EDS B. Cataplexy C. Hallucinations D. Sleep paralysis E. All four sxs
B
44
30-60% of pts A. EDS B. Cataplexy C. Hallucinations D. Sleep paralysis E. All four sxs
C
45
25-50% of pts A. EDS B. Cataplexy C. Hallucinations D. Sleep paralysis E. All four sxs
D
46
10-33% of pts A. EDS B. Cataplexy C. Hallucinations D. Sleep paralysis E. All four sxs
E
47
what do the following drugs treat? Sodium oxybate, Xywav, Lumryz
cataplexy in narcolepsy
48
What do the following drugs treat? Modafinil/armodafinil, sodium oxybate, pitolisant, solfriamfetol
EDS in narcolepsy
49
For adults and children >7 A. Xywav B. Lumryz
A
50
for adults only A. Xywav B. Lumryz
B
51
Approved for idiopathic hypersomnia in adults A. Xywav B. Lumryz
A
52
ER dosage form, once nightly dosing A. Xywav B. Lumryz
B
53
High sodium content A. Xywav B. Lumryz C. Sodium oxybate
B and C
54
low sodium content A. Xywav B. Lumryz C. Sodium oxybate
A
55
Associated with possible life-threatening rash A. Xywav B. Lumryz C. Sodium Oxybate D. Modafinil E. Armodafinil
D and E
56
Avoid use with centrally-acting H1 receptor antagonists (OTC antihistamines) A. Pitolisant B. Sodium Oxybate C. Solriamfetol D. Modafinil
A
57
Contraindicated in severe hepatic impairment A. Pitolisant B. Sodium Oxybate C. Solriamfetol D. Modafinil
A
58
H3 receptor antagonist/ inverse agonist A. Pitolisant B. Sodium Oxybate C. Solriamfetol D. Modafinil
A
59
go look more at the solriamfetol and pitolisant slides
okay
60
Drugs of choice for shift work sleep disorder
modafinil and armodafinil
61
when should you take modafinil and armodafinil for shift work sleep disorder?
1 hour before the. work period starts during "wake time"
62
drug of choice for restless leg syndrome
gabapentin enacarbil (prodrug of gabapentin)
63
What kind of supplementation may be considered in restless leg syndrome
iron
64
which two IR formulation dopamine agonists can be used in restless leg syndrome
pramipexole or ropinirole

PHRM 845 (34 decks)

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