sleep 2

Question 1

what melatonin agonist is used to improve sleep onset that effects primarily melatonin 1 receptors

Answer 1

ramelteon (Rozerem)

Question 2

what melatonin agonist has a balanced effect on all melatonin receptors; helps both sleep onset and sleep duration

Answer 2

tasimelteon

Question 3

what melatonin agonist is recommended for blind patients

Answer 3

tasimelteon

Question 4

what drug is a selective antagonist of orexin

Answer 4

suvorexant

Question 5

what are the adverse effects of suvorexant

Answer 5

1. hang over

2. cataplexy - ‘weak knees when laughing’

Question 6

75% of narcoleptics don’t have what neurotransmitter

Answer 6

hypocretin-orexin

Question 7

what is the most effective treatment for sleep disorders

Answer 7

cognitive behavioral therapy

Question 8

what are the most common forms of circadian rhythm disorders

Answer 8

jet lag

shift work

Question 9

what are 3 effects of working night shifts

Answer 9

1. decreased alertness
2. decreased performance
3. decreased quality of daytime sleep

Question 10

what two stimulants can be used to increase alertness for night shifts

Answer 10

armadofanil and modafinil

Question 11

why is modafinil not allowed in Europe for shift work (narcolepsy only)

Answer 11

increased risk for depression and other disorders

Question 12

what is obstructive sleep apnea

Answer 12

effort to breath, but obstruction of upper airway prevents

Question 13

what is the non-pharm treatment for obstructive sleep apnea

Answer 13

positice airway pressure (CPAP mask)

Question 14

what are adjunctive therapies for patients with sleep apnea on PAP

Answer 14

1. modafinil/ armodafinil
2. methylphenidates
3. amphetamines

Question 15

what is cataplexy

Answer 15

sudden bilateral loss of muscle tone without loss of consciousness

Question 16

what antidepressants are used to treat REM related disorders in narcolepsy

Answer 16

1. TCA’s
2. venlafaxine
3. fluoxetine

Question 17

what drug improves excessive daytime sleepiness and decreases cataplexia/ REM abnormalities

Answer 17

sodium oxybate (hydroybutyrate)

Question 18

what is used in narcolepsy to treat excessive day time sleepiness

Answer 18

modafinil/ armodafinil

Question 19

what is second line for REM related abnormalities in narcolepsy other than antidepressents

Answer 19

selegiline

Question 20

what is known as ‘liquid exstacy;

Answer 20

hydroxybutyrate

Question 21

what is restless leg syndrome

Answer 21

parestheisas felt deep in the calf muscle with the urge to move limb

Question 22

what are two common physiological causes of RLS

Answer 22

1. low dopamine levels in hypothalamic cells

2. iron deficiency within the CNS

Question 23

what are the treatments for RLS

Answer 23

1. stop alcohol caffeine, stress and fatigue
2. d/c dopamine blocking drugs
3. screen for iron deficiency
4. engaging mental activities reduce symptoms of boredom

Question 24

what is the agent of choice for RLS

Answer 24

dopamine agonists (pramipexole, ropinirole, rotigotine)

Question 25

what is term for repetitive movements of legs that occur during sleep

Answer 25

periodic limb movements of sleep (PLMS)