Sleep Disorders

Question 1

name short-acting Z drugs, which is shortest

Answer 1

zopiclone
zopiderm
zaleplon (shortest acting)

Question 2

what type of insomnia does short acting hypnotic treats

Answer 2

Sleep-ONSET insomnia

Question 3

which CD schedule does Z drug belong to

Answer 3

CD4.1

Question 4

name long-acting BZs

Answer 4

DNF - diazepam
nitrazepam
flurazepam

Question 5

what type of insomnia does long-acting BZ treat

Answer 5

sleep-MAINTAINANCE insomnia

Question 6

name short-acting BZs

Answer 6

LOLLT- lorazepam, oxazepam, loprazolam, lormetazepam, temazepam

Question 7

which BZ is CD schedule 3 instead of 4.1

Answer 7

temazepam

Question 8

what are the three types of insomnia

Answer 8

transient
short term
chronic

Question 9

name 4 other hypnotics

Answer 9

1 clomethiazole (also etOH w/d)
2 chloral hydrate (limited use)
3 antihistamines: promethazine, diphenhydramine (OTC)
4 melatonin (pineal hormone in >55)

Question 10

long term use of hypnotics can cause what complications (3)

Answer 10

1 dependece (14 days)
2 tolerance (only use PRN)
3 w/d symdrome (rebound insomnia)

Question 11

what to advise upon stopping hypnotics

Answer 11

sleep may be disturbed for a few days but broken sleep and vivid dreams can presist for weeks

Question 12

max duration of use for zaleplon

Answer 12

2 weeks

Question 13

MOA of Z drugs

Answer 13

act on GABAa rec to enhance GABA binding to receptors (GABA inhibitory NT in brain - sedation)

Question 14

SE of Zdrugs and BZs

Answer 14

1 paradoxial effects (aggression, anxiety)

2 daytime sleepiness (enhaced by alcohol)

Question 15

what is narcolepsy

Answer 15

inappropriate sudden onset of sleep, brain cannot regulate normal sleep wake cycle, sudden loss of muscle control (cataplexy)

Question 16

treatment for narcolepsy

Answer 16

CNS stimulants : modafinil CD2, methylphenidate CD2, Dexamfetamine CD2, sodium oxybate CD2, pitolisant (antihistamine)