Insomnia Flashcards

1
Q

MOA: orexin receptor antagonist

A

Suvorexant

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2
Q

Suvorexant is a ___

A

3A4 substrate - lower the dose if given with inhibitors

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3
Q

suvorexant is a ___ controlled substance

A

CN 4

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4
Q

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

A

tasimelteon

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5
Q

ADR of tasimelteon

A

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

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6
Q

DI of tasimelteon

A

CYP1A2 inihibitors (amiodarone, efavirenze, fluroquinolone)

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

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7
Q

Tasimelteon had ___ in animal studies

A

fetal harm

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8
Q

suvorexant ADR

A

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

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9
Q

ramelteon is a ___

A

CYP1A2 drug

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10
Q

directions for ramelteon

A

take on empty stomach within 30 min go to bed

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11
Q

melatonin receptor agonist drugs

A

ramelteon and tasimelteon

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12
Q

_____ melatonin receptor agonist is not recommeneded with hepatic impairment

A

tasimelteon

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13
Q

zaleplon MOA

A

BZD receptor agonist

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14
Q

zaleplon “niche” property

A

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

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15
Q

zaleplon brand

A

sonata

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16
Q

zolpidem is used for..

A

sleep onset and maintenance impairment

17
Q

___ BZD receptor agonist must start with lower dose for women

A

Zolpidem

18
Q

brand zolpidem

A

ambien

19
Q

main concerning adr of zolpidem

A

Parasomnias: sleep eat and drive

next day impairment

20
Q

zolpidem interacts with&raquo_space;>

A

? but its a 3A4 substrate

21
Q

pregnancy and CS ranking of zolpidem

A

preg C and C4

22
Q

indication esozopiclone

A

sleep onset and maintanence

23
Q

esozopiclone vs zolpidem

A

esozopiclone has longer half life and is dose dependent

24
Q

main esozopiclone adrs

A

bad taste, next day impairment

25
Q

esozopiclone is a

A

3A4 substrate

26
Q

esozopiclone interacts with

A

CNS depressants like alcohol

27
Q

temazepam is a __ used for ___

A

BZD for short term insomnia up to 2 wks

28
Q

triazolam is a __ used for __

A

BZD for pre op anxiety, its amnestic

29
Q

MOA of BZD receptor agonists

A

bind to GABA receptor at BZD one site

30
Q

benefits of BZD receptor agonist

A

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

31
Q

insomnia definition

A

dissatisified with sleep quality or quantitiy

32
Q

Dx criteria

A

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

33
Q

historical sleep aid

A

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

34
Q

meds for sleep latency

A

ZZERTT

Zaleplon 
Zolpidem 
Eszopiclone 
Ramelteon 
Triazolam
35
Q

sleep maintance meds

A
TEDZS 
Temazepam 
Esozopiccone 
Doxepin 
Zolpidem 
Suvorextant
36
Q

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

A

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