Hypnotics

Question 1

1st gen anti-histamines?

Answer 1

Diphenhydramine

Doxylamine

Question 2

Doxylamine clinical indiciations

Answer 2

nausea in pregnancy

Question 3

Pearls for 1st gen antihistamines?

Answer 3

take forever to work and work forever
tolerance can develop
combined often w/ APAP

Question 4

what drugs shouldn’t be combined w/ 1st gen anti-histamines?

Answer 4

anti-cholinergics

Question 5

who should we avoid 1st gen anti-histamines in?

Answer 5

elderly

Question 6

how long should someone take a break after 1st gen antihistamine use?

Answer 6

3 days

Question 7

what TCA is good for sleep?

Answer 7

Doxepin

Question 8

what Benzo is good for anterograde amnesia or complex sleep-related behaviors?

Answer 8

Triazolam

Question 9

what cannot be used with hypnotic benzos?

Answer 9

3A4 inhibtors

Question 10

Benzos used as hypnotics

Answer 10

triazolam
estazolam
temazepam
fluazepam
Quazepam

Question 11

3 NBRAs

Answer 11

Zaleplon
Zolpidem
Eszopiclone

Question 12

what are NBRA’s approved for?

Answer 12

sleep onset and maintenance

Question 13

who should have a lower dose of Zolpidem, Eszopiclone

Answer 13

elderly

females

Question 14

what type of amine TCA is doxepin

Answer 14

tertiary

Question 15

are NBRA’s scheduled? if so what #?

Answer 15

yes

IV

Question 16

what is a specific ADR of eszopiclone?

Answer 16

metallic aftertaste

Question 17

what are the 3 melatonin receptor agonists?

Answer 17

Melatonin
Ramelton
Tasimelton

Question 18

what do melatonin, ramelton, tasimelon help with?

Answer 18

falling asleep

ppl w/ shift work or BLIND–circadian rhythm issues

Question 19

what are melatonin, ramelton, tasmelon substates of?

Answer 19

1A2

3A4

Question 20

drugs approved for daytime sleepiness

Answer 20

modafinil

armodafinil

Question 21

3 anti-depressants for sleep

Answer 21

trazadone
mirtazapine
amitryptaline

Question 22

2nd gen anti-psych for sleep

Answer 22

quetiapine

Question 23

AED for sleep

Answer 23

gabapentin

pregabalin

Question 24

causes of insomnia

Answer 24

OSA
pain
depression/anxiety
caffiene
stimulants
diuretics

Question 25

1st step w/ insomnia

Answer 25

CBT

Question 26

2nd step w/ insomnia

Answer 26

pharm agent

Question 27

dosing for starting agent in insomnia

Answer 27

low and slow

Question 28

risk of using meds for insomnia

Answer 28

5x higher risk of death

Question 29

tasimelton indication

Answer 29

24 hour sleep-wake disorder

Question 30

most common NBRA used

Answer 30

zolpidem

Question 31

shortest maintenance NBRA drug

Answer 31

zaleplon

Question 32

what does agonizing MT1 cause?

Answer 32

sleepiness

Question 33

what does agonizing MT2 cause?

Answer 33

regulation of circadian rhythm

Question 34

use of ramelteon?

Answer 34

issues falling asleep

Question 35

use of tasimelton?

Answer 35

blind ppl w/o circadian rhythm–helps em out

Question 36

antidepressants that can help w/ sleep

Answer 36

trazodone
mirtazapine
amitripytline

Question 37

2nd gen Anti-psych that can help w/ sleep

Answer 37

quetiapine

Question 38

AED drugs that help w/ sleep

Answer 38

gabapentin

pregabalin