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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
Q

Nonbenzodiazepine GABA a hypntics effects

A

decrease sleep latency and # of awakenings, improve sleep duration and sleep quality

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26
Q

zaleplon brand name

A

sonata

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27
Q

zaleplon dosing

A

5-20 mg HS

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28
Q

zaleplon onset

A

rapid

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29
Q

zaleplon t 1/2

A

1 hour

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30
Q

zaleplon impact on sleep

A

sleep onset

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31
Q

AEs of zaleplon

A 
HA
dizziness
nausea
abdominal pain
somnolence
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32
Q

Special considerations of zaleplon

A

neither hangover or rebound insomnia are seen

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33
Q

Zolpidem brand names

A

Ambien
Zolpimist
Intermezzo

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34
Q

Zolpidem dosage

A

5-10 mg HS

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35
Q

Zolpidem onset

A

30 minutes

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36
Q

zolpidem t 1/2

A

1.5-2.4 hours

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37
Q

zolpidem sleep impact

A

sleep onset

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38
Q

zolpidem AEs

A

HA
dizziness
somnolence

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39
Q

zolpidem special considerations

A

neither hangover or rebound insomnia are seen

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40
Q

Zolpidem CR brand name

A

Ambien CR

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41
Q

zolpidem CR dose

A

6.25 - 12.5 mg HS

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42
Q

onset of zolpidem CR

A

30 minutes

43
Q

t 1/2 of zolpidem CR

A

1.5-2.4 hours

44
Q

zolpidem CR impact on sleep

A

sleep onset

sleep maintenance

45
Q

Eszopiclone brand name

A

lunesta

46
Q

eszopiclone dosing

A

1-3 mg HS

47
Q

eszopiclone onset

A

30 minutes

48
Q

eszopiclone t 1/2

A

5-7 hours

49
Q

eszopiclone impact on sleep

A

sleep onset

sleep maintenance

50
Q

special considerations with eszopiclone

A

caution in depression (suicidal)

51
Q

what is melatonin

A

hormone secreted by the pineal gland

52
Q

Ramelteon MOA

A

selective melatonin receptor agonist (MT1 and MT2)

53
Q

Ramelteon brand name

A

Rozerem

54
Q

Ramelteon effect on sleep

A

sleep induction

55
Q

Antidepressants used for sleep

A

TCAs(imipramine, doxepin)
Trazodone
Mirtazepine

56
Q

Antipsychotics used for sleep

A

quetiapine

57
Q

Antihistamines effects

A

decreased alertness, diminished cognitive function, delirium, dry mouth, blurred vision, urinary retention, constipation, and increased intraocular pressure

58
Q

antihistamines used for sleep

A

diphenhydramine

doxylamine

59
Q

Orexin receptor antagonist used for sleep

A

suvorexant

60
Q

suvorexant brand name

A

belsomra

61
Q

suvorexant MOA

A

orexin A and B are hypothalmic neuropeptides playing a key role in wakefulness and regulating sleep wake cycle

62
Q

2 types of sleep apnea

A

obstructive

central

63
Q

define obstructive sleep apnea

A

repeated episodes of nocturnal breathing cessation with loud snoring and gasping

64
Q

define central sleep apnea

A

repeated episodes of apnea caused by temporary loss of respiratory effect during sleep

65
Q

medications used for excessive somnolence in Narcolepsy

A 
dextroamphetamine
dextroamphetamine/amphetamine 
Methamphetamine
Methylphenidate
Modafinil
Armodafinil
66
Q

Adjunct agents used for cataplexy in narcolepsy

A 
fluoxetine
imipramine
protriptyline
nortriptyline
selegiline
sodium oxybate (gamma hydroybutyrate
67
Q

dextroamphetamine brand name

A

dexedrine

68
Q

dextroamphetamine dosage for narcolepsy

A

5-60 mg

69
Q

dextroamphetamine/amphetamine salts brand name

A

Adderall

70
Q

adderall dose for narcolepsy

A

5-60 mg

71
Q

methamphetamine brand name

A

desoxyn

72
Q

methamphetamine dose for narcolepsy

A

5-15 mg

73
Q

methylphenidate brand name

A

ritalin

74
Q

methylphenidate dose for narcolepsy

A

30-80 mg

75
Q

Modafinil brand name

A

provigil

76
Q

modafinil dose for narcolepsy

A

200-400 mg

77
Q

armodafinil brand name

A

nuvigil

78
Q

armodafinil dose for narcolepsy

A

150-250 mg

79
Q

fluoxetine brand name

A

prozac

80
Q

imipramine brand name

A

tofranil

81
Q

fluoxetine dose for cataplexy

A

20-80 mg

82
Q

imipramine dose for cataplexy

A

50-250 mg

83
Q

proptriptyline brand name

A

vivactil

84
Q

protriptyline dose for cataplexy

A

5-30 mg

85
Q

nortriptyline brand name

A

pamelor

86
Q

nortriptyline dose for cataplexy

A

50-200 mg

87
Q

selegiline brand name

A

eldepryl

88
Q

selegiline dose for cataplexy

A

20-40 mg

89
Q

Sodium oxybate (gamma hydroxybutyrate) brand name

A

xyrem

90
Q

sodium oxybate dose for cataplexy

A

6-9 grams/day

91
Q

name 2 circadian rhythm disorders

A

jet lag

shift work sleep disorders

92
Q

define restless leg syndrome

A

paresthesias that are felt deep in the calf muscles and cause the urge to keep the legs in motion

93
Q

underlying causes of restless leg

A 
uremia
iron deficiency anemia
pregnancy 
caffeine
stress and fatigue
drug-induced
94
Q

4 treatment options for restless leg

A

ropinirole
pramipexole
gabapentin
clonazepam

95
Q

ropinirole brand name

A

requip

96
Q

ropinirole dosing for restless leg

A

0.25mg one hour before bedtime. up to 4 mg HS

97
Q

pramipexole brand name

A

mirapex

98
Q

pramipexole dose for restless leg

A

0.25 mg one hour before bedtime. up to 0.75 mg HS

99
Q

Gabapentin brand name

A

horizant

100
Q

gabapentin dose for restless leg

A

300 mg HS up to 900 mg HS

101
Q

clonazepam brand name

A

Klonopin

102
Q

Clonazepam dose for restless leg

A

0.5 mg HS up to 3 mg HS

103
Q

define parasomnia

A

acute, episodic, physical phenomena that occur either exclusively during sleep or are exaggerated by sleep

104
Q

3 types of parasomnias

A

somnambulism
sleep terrors
nightmares

Pnt exam 3 (8 decks)

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