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PHRM 845 > L? Sleep disorders Ott > Flashcards

L? Sleep disorders Ott Flashcards

1
Q

diagnostic criteria of insomnia:
how often?
how long?

A

at least 3 nights per week for 3 months

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2
Q

what is the only benzo that ott says is used even though they all “can be”

A

temazepam

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3
Q

first line tx of insomnia disorders

A

sleep hygiene principles

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4
Q

Most commonly used sleep meds?

A

z-hypnotics
(zolpidem, eszopiclone, zaleplon)

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5
Q

What is the initial dose of zolpidem in women and elderly?

A

5 mg (lower)

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6
Q

which z-hypno is FDA approved for long term use

A

eszopiclone

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7
Q

which z-hypno leaves pts complaining of metallic taste

A

eszopiclone

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8
Q

T or F: all 3 z-hypnos are CYP2D6 substrates

A

false, 3A4

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9
Q

4 side effects of z-hypnos

A

somnolence
dizziness
ataxia
headaches

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10
Q

what is a warning on all z-hypnos?

A

parasomnias - unusual actions while someone is sleeping

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11
Q

T or F: All but 1 of the z-hypnos is a control

A

false, they all are

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12
Q

Contraindicated with fluvoxamine
A. Ramelteon
B. Tasimelteon

A

A. Ramelteon

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13
Q

GI upset, next day somnolence, hyperprolactinemia, prolactinemia
A. Ramelteon
B. Tasimelteon

A

A. Ramelteon

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14
Q

FDA approved for non-24 sleep-wake disorder in adults
A. Ramelteon
B. Tasimelteon

A

B. Tasimelteon

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15
Q

1A2 substrate: watch for 1A2 inducers and inhibitors
A. Ramelteon
B. Tasimelteon

A

both

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16
Q

what do the 3 orexin receptor antagonists end with

A
  • orexant
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17
Q

aim for at least 7 hours of sleep after taking
A. Suvorexant
B. Lemborexant
C. Daridorexant

A

all

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18
Q

contraindicated in narcolepsy bc of narcolepsy-like side effects
A. Suvorexant
B. Lemborexant
C. Daridorexant

A

all

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19
Q

3A4 substrate
A. Suvorexant
B. Lemborexant
C. Daridorexant

A

all

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20
Q

TCA - low doses exert effects through H1 antagonism
A. Doxepin
B. Trazodone

A

A. Doxepin

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21
Q

Anticholinergic side effects
A. Doxepin
B. Trazodone

A

A. Doxepin

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22
Q

Not FDA-approved for insomnia
A. Doxepin
B. Trazodone

A

B. Trazodone

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23
Q

Long half-life, may see daytime hangover
A. Doxepin
B. Trazodone

A

B. Trazodone

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24
Q

used as sleep agent especially in pts w/ depression
A. Mirtazapine
B. Quetiapine

A

A. Mirtazapine

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25
Q

low dose not recommended in insomnia unless there is a co-morbid psych disorder
A. Mirtazapine
B. Quetiapine

A

B. Quetiapine

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26
Q

Not recommended by AASM
A. bendaryl/doxylamine
B. Melatonin
C. Valerian
D. Chamomile

A

A

27
Q

Anticholinergic side effects
A. bendaryl/doxylamine
B. Melatonin
C. Valerian
D. Chamomile

A

A

28
Q

Can be considered in jet lag
A. bendaryl/doxylamine
B. Melatonin
C. Valerian
D. Chamomile

A

B

29
Q

1A2 substrate
A. bendaryl/doxylamine
B. Melatonin
C. Valerian
D. Chamomile

A

B

30
Q

contains a BZD-like compound
A. bendaryl/doxylamine
B. Melatonin
C. Valerian
D. Chamomile

A

D

31
Q

allergic reactions in pts w/ daisy or ragweed allergies
A. bendaryl/doxylamine
B. Melatonin
C. Valerian
D. Chamomile

A

D

32
Q

AASM 1st line therapy

A

CBT and behavioral therapies

33
Q

diagnostic criteria of obstructive sleep apnea

A

at least 5 obstructive apneas per hour of sleep confirmed by polysomnography

34
Q

T or F: clinically, there is greater recognition that many pts have apnea and insomnia

A

true

35
Q

T or F: if a pt has apnea and insomnia, treat insomnia first

A

false, apnea first

36
Q

at least 1 of 6 things needs to be present for use of a polysomnography in obstructive sleep apnea, what are they?

A
  • cardiorespiratory disease
  • muscle weakness due to neuro-muscular condition
  • sleep-related hypoventilation
  • chronic opioid use
  • stroke
  • severe insomnia
37
Q

What is the first non-pharm option you should consider in the tx of sleep apnea?

A

weight loss

38
Q

T or F: Sleeping on stomach rather than back will help sleep apneas

A

False, sleep on side

39
Q

what tf is CPAP?

A

continuous positive airway pressure

40
Q

what two drugs can treat excessive daytime sleepiness in sleep apnea (maybe others too idk)

A

modafinil and armodafinil

41
Q

what 3 things are included in the narcolepsy triad?

A

EDS
hallucinations
Sleep paralysis

42
Q

100% of pts
A. EDS
B. Cataplexy
C. Hallucinations
D. Sleep paralysis
E. All four sxs

A

A

43
Q

75% of pts
A. EDS
B. Cataplexy
C. Hallucinations
D. Sleep paralysis
E. All four sxs

A

B

44
Q

30-60% of pts
A. EDS
B. Cataplexy
C. Hallucinations
D. Sleep paralysis
E. All four sxs

A

C

45
Q

25-50% of pts
A. EDS
B. Cataplexy
C. Hallucinations
D. Sleep paralysis
E. All four sxs

A

D

46
Q

10-33% of pts
A. EDS
B. Cataplexy
C. Hallucinations
D. Sleep paralysis
E. All four sxs

A

E

47
Q

what do the following drugs treat? Sodium oxybate, Xywav, Lumryz

A

cataplexy in narcolepsy

48
Q

What do the following drugs treat?
Modafinil/armodafinil, sodium oxybate, pitolisant, solfriamfetol

A

EDS in narcolepsy

49
Q

For adults and children >7
A. Xywav
B. Lumryz

A

A

50
Q

for adults only
A. Xywav
B. Lumryz

A

B

51
Q

Approved for idiopathic hypersomnia in adults
A. Xywav
B. Lumryz

A

A

52
Q

ER dosage form, once nightly dosing
A. Xywav
B. Lumryz

A

B

53
Q

High sodium content
A. Xywav
B. Lumryz
C. Sodium oxybate

A

B and C

54
Q

low sodium content
A. Xywav
B. Lumryz
C. Sodium oxybate

A

A

55
Q

Associated with possible life-threatening rash
A. Xywav
B. Lumryz
C. Sodium Oxybate
D. Modafinil
E. Armodafinil

A

D and E

56
Q

Avoid use with centrally-acting H1 receptor antagonists (OTC antihistamines)
A. Pitolisant
B. Sodium Oxybate
C. Solriamfetol
D. Modafinil

A

A

57
Q

Contraindicated in severe hepatic impairment
A. Pitolisant
B. Sodium Oxybate
C. Solriamfetol
D. Modafinil

A

A

58
Q

H3 receptor antagonist/ inverse agonist
A. Pitolisant
B. Sodium Oxybate
C. Solriamfetol
D. Modafinil

A

A

59
Q

go look more at the solriamfetol and pitolisant slides

A

okay

60
Q

Drugs of choice for shift work sleep disorder

A

modafinil and armodafinil

61
Q

when should you take modafinil and armodafinil for shift work sleep disorder?

A

1 hour before the. work period starts during “wake time”

62
Q

drug of choice for restless leg syndrome

A

gabapentin enacarbil (prodrug of gabapentin)

63
Q

What kind of supplementation may be considered in restless leg syndrome

A

iron

64
Q

which two IR formulation dopamine agonists can be used in restless leg syndrome

A

pramipexole or ropinirole

PHRM 845 (34 decks)

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