Insomnia drugs

Question 1

Nonbenzodiazepine hypnotics?

Answer 1

Zolpidem, Zaleplon, Eszopiclone.

Question 2

Nonbenzodiazepine hypnotics. Act on what receptors?

Answer 2

Act via BZ1 subtype of the GABA receptor.

Question 3

Nonbenzodiazepine hypnotics. What reverses effect?

Answer 3

Flumazenil (same as BZD)

Question 4

Nonbenzodiazepine hypnotics. How affect sleep cycles compared to BZD?

Answer 4

Sleep cycles are less affected as compared with BZD hypnotics

Question 5

Nonbenzodiazepine hypnotics. Indications?

Answer 5

Insomnia

Question 6

Nonbenzodiazepine hypnotics. Risk of dependence?

Answer 6

Less than with BZD

Question 7

Nonbenzodiazepine hypnotics. Adverse?

Answer 7

Ataxia, headaches, confusion.

Question 8

Nonbenzodiazepine hypnotics. Duration of effect?

Answer 8

short duration because of rapid metabolism by liver enzymes

Question 9

Nonbenzodiazepine hypnotics. level of psychomotor depression?

Answer 9

Only modest day-after psychomotor depression and few amnestic effects.

Question 10

Suvorexant mechanism?

Answer 10

Orexin (hypocretin) receptor antagonist

Question 11

Suvorexant indication?

Answer 11

Insomnia

Question 12

Suvorexant adverse?

Answer 12

CNS depression (somnolence), headache, abnormal sleep-related activities.

Question 13

Suvorexant. Contraindications?

Answer 13

narcolepsy, combination with strong CYP3A4 inhibitors.

Question 14

Suvorexant. Not recommended for what patients?

Answer 14

with liver diseases

Question 15

Suvorexant dependence?

Answer 15

Limited physical dependence or abuse potential.

Question 16

Ramelteon. Mechanism?

Answer 16

Melatonin receptor agonist.

Question 17

Ramelteon. Bind melatonin rec. where?

Answer 17

Binds MT1 and MT2 in SUPRACHIASMATIC NUCLEUS

Question 18

Ramelteon. indications?

Answer 18

Insomnia

Question 19

Ramelteon. Adverse?

Answer 19

Dizziness, nausea, fatigue, headache.

Question 20

Ramelteon. Dependence?

Answer 20

No dependence.