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Flashcards in sleep 2 Deck (25)
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1

what melatonin agonist is used to improve sleep onset that effects primarily melatonin 1 receptors

ramelteon (Rozerem)

2

what melatonin agonist has a balanced effect on all melatonin receptors; helps both sleep onset and sleep duration

tasimelteon

3

what melatonin agonist is recommended for blind patients

tasimelteon

4

what drug is a selective antagonist of orexin

suvorexant

5

what are the adverse effects of suvorexant

1. hang over
2. cataplexy - 'weak knees when laughing'

6

75% of narcoleptics don't have what neurotransmitter

hypocretin-orexin

7

what is the most effective treatment for sleep disorders

cognitive behavioral therapy

8

what are the most common forms of circadian rhythm disorders

jet lag
shift work

9

what are 3 effects of working night shifts

1. decreased alertness
2. decreased performance
3. decreased quality of daytime sleep

10

what two stimulants can be used to increase alertness for night shifts

armadofanil and modafinil

11

why is modafinil not allowed in Europe for shift work (narcolepsy only)

increased risk for depression and other disorders

12

what is obstructive sleep apnea

effort to breath, but obstruction of upper airway prevents

13

what is the non-pharm treatment for obstructive sleep apnea

positice airway pressure (CPAP mask)

14

what are adjunctive therapies for patients with sleep apnea on PAP

1. modafinil/ armodafinil
2. methylphenidates
3. amphetamines

15

what is cataplexy

sudden bilateral loss of muscle tone without loss of consciousness

16

what antidepressants are used to treat REM related disorders in narcolepsy

1. TCA's
2. venlafaxine
3. fluoxetine

17

what drug improves excessive daytime sleepiness and decreases cataplexia/ REM abnormalities

sodium oxybate (hydroybutyrate)

18

what is used in narcolepsy to treat excessive day time sleepiness

modafinil/ armodafinil

19

what is second line for REM related abnormalities in narcolepsy other than antidepressents

selegiline

20

what is known as 'liquid exstacy;

hydroxybutyrate

21

what is restless leg syndrome

parestheisas felt deep in the calf muscle with the urge to move limb

22

what are two common physiological causes of RLS

1. low dopamine levels in hypothalamic cells
2. iron deficiency within the CNS

23

what are the treatments for RLS

1. stop alcohol caffeine, stress and fatigue
2. d/c dopamine blocking drugs
3. screen for iron deficiency
4. engaging mental activities reduce symptoms of boredom

24

what is the agent of choice for RLS

dopamine agonists (pramipexole, ropinirole, rotigotine)

25

what is term for repetitive movements of legs that occur during sleep

periodic limb movements of sleep (PLMS)