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Pnt exam 3 > sleep > Flashcards

sleep Flashcards

1
Q

Waves in stage 1 sleep

A

alpha to theta waves

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2
Q

what in stage 2 sleep

A

sleep spindles and K complexes

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3
Q

waves in stage 3+4 sleep

A

delta waves

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4
Q

What sleep is deep sleep

A

stages 3+ 4

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5
Q

What sleep stage is restorative

A

stages 3+ 4

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6
Q

What is REM sleep

A

dreaming, paradoxical sleep

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7
Q

Where controls non-REM sleep

A

basal forebrain

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8
Q

What turns on Rem in the brain

A

cholinergic cells in the mesencephalic, medullary, and pontine gigantocellular regions

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9
Q

What turns off REM in the brain

A

dorsal raphe nucleus, locus cereleus, and nucleus parabachialis lateralis

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10
Q

What neurotransmitters promote wakefulness

A 
norepinephrine
acetylcholine
histamine
increase dopamine
neuropeptides
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11
Q

how many nights per week to diagnose insomnia

A

3+

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12
Q

how many months of symptoms to diagnose insomnia

A

3

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13
Q

episodic insomnia

A

1-3 months

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14
Q

persistant insomnia

A

3+ months

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15
Q

recurrent insomnia

A

2+ episodes in the space of 1 year

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16
Q

what is situational/acute insomnia

A

lasts a few days to a few weeks, usually associated with life events or sleep schedule changes

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17
Q

Non-pharm treatment for insomnia

A

sleep hygiene
stimulus control
treat underlying disorders

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18
Q

Pharm treatment options for insomnia

A 
benzodiazepine receptor agonists (Hypnotics) 
Barbituate Hypnotics
non-benzodiazepine GABA-a hypnotics
miscellaneous
antidepressants 
antipsychotics
antihistamines
orexin receptor antagonists
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19
Q

MOA of benzodiazepine receptor agonists

A

bind to several GABA type A receptor subtypes

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20
Q

Effect of benzodiazepine receptor agonists

A

reduce time to onset, prolong stage 2 sleep, prolong total sleep, and may reduce REM, decrease anxiety, impair memory, and have anticonvulsive properties

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21
Q

name 2 short acting benzodiazepine receptor agonists

A

triazolam

alprazolam

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22
Q

name 4 intermediate acting benzodiazepine receptor agonists

A

estazolam
lorazepam
temazepam
clonazepam

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23
Q

name 2 long acting benzodiazepine receptor agonists

A

flurazepam

quazepam

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24
Q

which two benzodiazepine receptor agonists have active metabolites

A

flurazepam

quazepam

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25
Nonbenzodiazepine GABA a hypntics effects
decrease sleep latency and # of awakenings, improve sleep duration and sleep quality
26
zaleplon brand name
sonata
27
zaleplon dosing
5-20 mg HS
28
zaleplon onset
rapid
29
zaleplon t 1/2
1 hour
30
zaleplon impact on sleep
sleep onset
31
AEs of zaleplon
``` HA dizziness nausea abdominal pain somnolence ```
32
Special considerations of zaleplon
neither hangover or rebound insomnia are seen
33
Zolpidem brand names
Ambien Zolpimist Intermezzo
34
Zolpidem dosage
5-10 mg HS
35
Zolpidem onset
30 minutes
36
zolpidem t 1/2
1.5-2.4 hours
37
zolpidem sleep impact
sleep onset
38
zolpidem AEs
HA dizziness somnolence
39
zolpidem special considerations
neither hangover or rebound insomnia are seen
40
Zolpidem CR brand name
Ambien CR
41
zolpidem CR dose
6.25 - 12.5 mg HS
42
onset of zolpidem CR
30 minutes
43
t 1/2 of zolpidem CR
1.5-2.4 hours
44
zolpidem CR impact on sleep
sleep onset | sleep maintenance
45
Eszopiclone brand name
lunesta
46
eszopiclone dosing
1-3 mg HS
47
eszopiclone onset
30 minutes
48
eszopiclone t 1/2
5-7 hours
49
eszopiclone impact on sleep
sleep onset | sleep maintenance
50
special considerations with eszopiclone
caution in depression (suicidal)
51
what is melatonin
hormone secreted by the pineal gland
52
Ramelteon MOA
selective melatonin receptor agonist (MT1 and MT2)
53
Ramelteon brand name
Rozerem
54
Ramelteon effect on sleep
sleep induction
55
Antidepressants used for sleep
TCAs(imipramine, doxepin) Trazodone Mirtazepine
56
Antipsychotics used for sleep
quetiapine
57
Antihistamines effects
decreased alertness, diminished cognitive function, delirium, dry mouth, blurred vision, urinary retention, constipation, and increased intraocular pressure
58
antihistamines used for sleep
diphenhydramine | doxylamine
59
Orexin receptor antagonist used for sleep
suvorexant
60
suvorexant brand name
belsomra
61
suvorexant MOA
orexin A and B are hypothalmic neuropeptides playing a key role in wakefulness and regulating sleep wake cycle
62
2 types of sleep apnea
obstructive | central
63
define obstructive sleep apnea
repeated episodes of nocturnal breathing cessation with loud snoring and gasping
64
define central sleep apnea
repeated episodes of apnea caused by temporary loss of respiratory effect during sleep
65
medications used for excessive somnolence in Narcolepsy
``` dextroamphetamine dextroamphetamine/amphetamine Methamphetamine Methylphenidate Modafinil Armodafinil ```
66
Adjunct agents used for cataplexy in narcolepsy
``` fluoxetine imipramine protriptyline nortriptyline selegiline sodium oxybate (gamma hydroybutyrate ```
67
dextroamphetamine brand name
dexedrine
68
dextroamphetamine dosage for narcolepsy
5-60 mg
69
dextroamphetamine/amphetamine salts brand name
Adderall
70
adderall dose for narcolepsy
5-60 mg
71
methamphetamine brand name
desoxyn
72
methamphetamine dose for narcolepsy
5-15 mg
73
methylphenidate brand name
ritalin
74
methylphenidate dose for narcolepsy
30-80 mg
75
Modafinil brand name
provigil
76
modafinil dose for narcolepsy
200-400 mg
77
armodafinil brand name
nuvigil
78
armodafinil dose for narcolepsy
150-250 mg
79
fluoxetine brand name
prozac
80
imipramine brand name
tofranil
81
fluoxetine dose for cataplexy
20-80 mg
82
imipramine dose for cataplexy
50-250 mg
83
proptriptyline brand name
vivactil
84
protriptyline dose for cataplexy
5-30 mg
85
nortriptyline brand name
pamelor
86
nortriptyline dose for cataplexy
50-200 mg
87
selegiline brand name
eldepryl
88
selegiline dose for cataplexy
20-40 mg
89
Sodium oxybate (gamma hydroxybutyrate) brand name
xyrem
90
sodium oxybate dose for cataplexy
6-9 grams/day
91
name 2 circadian rhythm disorders
jet lag | shift work sleep disorders
92
define restless leg syndrome
paresthesias that are felt deep in the calf muscles and cause the urge to keep the legs in motion
93
underlying causes of restless leg
``` uremia iron deficiency anemia pregnancy caffeine stress and fatigue drug-induced ```
94
4 treatment options for restless leg
ropinirole pramipexole gabapentin clonazepam
95
ropinirole brand name
requip
96
ropinirole dosing for restless leg
0.25mg one hour before bedtime. up to 4 mg HS
97
pramipexole brand name
mirapex
98
pramipexole dose for restless leg
0.25 mg one hour before bedtime. up to 0.75 mg HS
99
Gabapentin brand name
horizant
100
gabapentin dose for restless leg
300 mg HS up to 900 mg HS
101
clonazepam brand name
Klonopin
102
Clonazepam dose for restless leg
0.5 mg HS up to 3 mg HS
103
define parasomnia
acute, episodic, physical phenomena that occur either exclusively during sleep or are exaggerated by sleep
104
3 types of parasomnias
somnambulism sleep terrors nightmares

Pnt exam 3 (8 decks)

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