Insomnia

Question 1

Insomnia diagnostic criteria

Answer 1

symptoms cause significant functional distress or impairment, present for >3 nights per week for at least 3 months, not linked to other disorders

Question 2

Sedative Hypnotics

Answer 2

Benzodiazepines- Temazepam, Triazolam

Question 3

Temazepam indications

Answer 3

short term treatment up to 2 weeks

Question 4

Triazolam indications

Answer 4

pre-op anxiety

Question 5

Benzodiazepine receptor agonists MOA

Answer 5

binds GABA receptor at BDZ 1 site for targeted sedation

Question 6

BDZ receptor agonist indications

Answer 6

first line short term treatment of insomnia

Question 7

BDZ receptor agonists

Answer 7

Zolpidem (ambien), Eszopicolone (lunesta)

Question 8

Zolpidem indications

Answer 8

sleep onset and sleep maintenance insomnia

Question 9

Zolpidem ADR

Answer 9

Parasomnias, rebound insomnia, drowsiness, allergic reactions, angioedema, dry mouth, abdominal pain, HA, strange behavior

Question 10

Zolpidem interactions

Answer 10

3A4 substrate, CNS depressants, EtOH

Question 11

Eszopicolone indications

Answer 11

sleep latency and sleep maintenance

Question 12

Eszopicolone ADRs

Answer 12

unpleasant taste, HA, infections, next day impairment, parasomnias, anaphylaxis, angioedema,

Question 13

Eszopicolone interactions

Answer 13

CNS depressants, 3A4 substrate, EtOH

Question 14

Zaleplon (sonata) indications

Answer 14

sleep latency and maintenance, can be taken nocturnal

Question 15

Zaleplon ADR

Answer 15

HA, dizziness, somnolence, complex behavior, anaphylaxis

Question 16

Melatonin MOA

Answer 16

hormone produced by pineal gland

Question 17

Melatonin indications

Answer 17

Sleep latency, Jet lag, insomnia

Question 18

Melatonin ADR

Answer 18

well tolerated, drowsiness, HA,

Question 19

Melatonin interactions

Answer 19

potentiates anticoag, inhibits AED

Question 20

Ramelteon MOA

Answer 20

melatonin receptor agonist

Question 21

Ramelteon indications

Answer 21

sleep latency

Question 22

Ramelteon ADR

Answer 22

somnolence, fatigue, dizziness

Question 23

Ramelteon contraindications

Answer 23

liver disease

Question 24

Tasimelteon

Answer 24

first treatment for non-24- hour sleep waked disorder

Question 25

Tasimelteon MOA

Answer 25

melatonin receptor agonists

Question 26

Tasimelteon ADR

Answer 26

somnolence, HA, increased LFT, nightmares, URI, UTI

Question 27

Tasimelteon interactions

Answer 27

CYP1A2 inhibitors, CYP3A4 inducers

Question 28

Suvorexant MOA

Answer 28

orexin receptor antagonist. Suppresses wake drive

Question 29

Suvorecant indications

Answer 29

sleep latency and sleep maintenance

Question 30

Suvorexant ADR

Answer 30

next day impairment, complex behaviors, depression, decreased resp, hallucinations, sleep paralysis

Question 31

Suvorexant contraindications

Answer 31

narcolepsy

Question 32

Doxepin

Answer 32

antidepressant with antihistamine effects

Question 33

Doxepin contraindication

Answer 33

urinary retention, glaucoma, MAOIs

Question 34

Doxepin ADR

Answer 34

suicide risk, daytime sedation, dry mouth, dry eyes, orthostasis, arrhythmias

Question 35

Antipsychotics

Answer 35

quetiapine, olanzapine

Question 36

Valerian Root

Answer 36

sedative-hypnotic, anxiolytic, antidepressant, anticonvulsant, antispasmodic

Question 37

Valerian Root ADR

Answer 37

HA, GI upset, mental dullness, excitability, uneasiness, cardiac disturbances, insomnia

Question 38

First line

Answer 38

CBT, Zolpidem, eszopiclone, suvorexant