Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych > Sleep Disorders and Tx > Flashcards

Sleep Disorders and Tx Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

What are the Sleep Disorders Medication classes?

A

Benzodiazepines

Bensodiazepines Receptors Agonist

Antihistamines

Antidepressants

Dopaminergic Agents

Dopamine Agonists

Anticonvulsants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Drug Classes used for Insomnia

A

Orexin Receptor Antagonists

Melatonin Agonists

Antidpressants

Antihistamines

Benzodiazepine receptor agonists

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Benzodiazepines:

  • drug names
  • MOA
  • what are the short, intermediate, and long acting meds?
A

Drug names:

  • Xanax (alprazolam)
  • ProSom (estazolam)
  • Dalmane (Flurazepam)
  • Ativan (Lorazepam)
  • Doral (Quazepam)
  • Restoril (Temazepam)
  • Halcion (Triazolam)

MOA:
-enhances the effects of GABA in the CNS (inhibitory NT)

Short:
-Triazolam (Halcion)

Intermediate:

  • Temazepam (Restoril)
  • Estazolam (ProSom)

Long acting;

  • Flurazepam (Dalmane)
  • Quazepam (Doral)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is it a good idea to use short, intermediate and long acting Benzos for insomnia?

A

Short: those who have difficulty falling asleep

Intermediate: those who have trouble staying asleep

Long: those who have difficultng falling asleep and maintaining sleep.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Benzodiazepines:

  • Adverse Effects
  • Interactions
  • CI
A

Adverse Effects:

  • drowsiness
  • impaired motor function
  • prolonged use (physical dependency*)
  • short term memory loss, confusion, shakiness

Interactions:

  • caution with alcohol
  • low dose contraceptives; decreases clearance of benzos

CI:

  • acute narrow-angle glaucoma
  • Preg X
  • Lactation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Benzodiazepine Receptors Agonists (BRA)

  • half life
  • develop dependency?
  • medication names
A

Half life: 5hrs
*Short half life, limits sleepiness or grogginess the next day.

Do not develop dependency

Drugs:

  • Lunesta (Eszopiclone)
  • Ambien (Zolpidem)
  • Sonata (Zaleplon)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lunesta (Eszopiclone)

  • MOA
  • Dosage
  • good for what type of insomnia?
  • adverse effects
  • CI
  • Preg Category
A

MOA: interacts with GABA receptors located near benzodiazepine receptors

Dosage:

  • start at 2mg immediately before bed, can increase to 3mg
  • elderly: start at 1mg, can increase to 2mg

Good for those with sleep maintenance issues

Adverse Effects;
-HA, dry mouth, dizziness, unpleasant taste with high dosages

CI:
-hypersensitivity; basically no CI.

Preg Cat. C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lunesta:

  • half life?
  • peak concentration?
  • special instructions
A

Half life: 5-7hrs; this is the longest half life of non-benzos)

Peak concentrations: 1hr

Special instructions:
-dont take after eating mean high in fat content, this delays absorption of medication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ambien (Zolpidem)

  • MOA
  • Dosage
  • Adverse Effects
  • CI
  • Preg Category
A

MOA: modulates GABA receptors to suppress neurons

Dosage:

  • 5-10mg PQ qhs
  • ER (extended release) 6.25-12.5PO qhs
  • lower doses on the elderly and women

Adverse Effects:

  • morning drowsiness
  • hangover
  • HA

CI:
hypersensitivity; clean drug

Preg Cat: C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ambien

  • Half life
  • response time
  • used first line for what type of insomnia?
A

Half life: 2.5hrs

Response time is immediate, 30minutes

ER:
works in 30minutes, half life is 3 hrs, duration is 6-8hrs

Used first line for those with trouble falling asleep.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Sonata (Zaleplon)

  • MOA
  • dosage
  • what type of insomnia?
  • onset and halflife
  • adverse effects
  • CI
  • pregnancy cat
A

MOA: interacts with GABA-BZ omega 1 receptor; causes sedation, muscle relaxation, anticonvulsant activity

Dosage:

  • 10mg PO qhs
  • range 5-20mg qhs

Good for those who have difficulty falling asleep, 2nd line to ambien. can be taken within 5hrs of scheduled wake up time.

Onset 1hr, half life is 1hr

Adverse Effects:

  • back or chest pain
  • migraine
  • constipation

CI: hypersensitivity; clean drug :)

Pregnancy Cat C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antihistamines:

  • drugs
  • MOA
  • dosage
  • Adverse events
  • pregnancy cat
  • is this normally prescribed for insomnia?
A

Drugs: diphenhydramine (Benadryl)

MOA: unknown, acts as CNS depressant

Dosage: 25-50mg qhs

Adverse effects:

  • excessive daytime drowsiness, impaired psychomotor function
  • dry mouth, delerium
  • anticholinergic effects

Pregnancy Cat B

Usually not recommended for insomnia, though people use it anyhow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antidepressants

  • drugs
  • which one is the only one with FDA approval?
A

Drugs:

  • Impiramine (Tofranil)
  • Amitryptyline hydrochloride (Elavil)
  • Nortryptyline (Pamelor)

New agents: used in pts who have anxiety or panic component to their insomnia.

  • Nefazodone hydrochloride (Serzone)
  • Venlafaxine (Effexor)

Silenor is the only one FDA approved for insomnia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Doxepin (Silenor)

  • MOA
  • dosage
  • Adverse events
  • good for what type of insomnia?
  • special instructions
A

MOA:
-increases synaptic concentrations of serotonin and NE in the CNS

Dosage; 3-6mg within 30mints of bedtime

Adverse Events:

  • drowsiness
  • dizziness
  • constipation
  • blurred vision

Good for sleep maintenance

Instructions:
-dont take within 3 hrs after eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Doxepin (Silenor)

  • CI
  • BBW
  • Preg cat
A

CI:

  • glaucoma
  • urinary retention

BBW:
-suicidal thoughts/behavior

Preg Cat C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Trazodone:

  • MOA
  • Dosage
  • Onset and half life
  • Caution in which pt population?
  • adverse events
  • CI
  • Preg cat?
  • BBW
A

MOA:
-inhibits reuptake of serotonin and causes adrenoreceptor subsensitivity

Dosage: 50-100mg before bed

Onset: 1-3hrs half life: 5-9hrs

Caution in obese pts, the half life can be longer.

Adverse events:

  • dizziness, drowsiness
  • blurred vision, confusion

CI:

  • use of MAOI
  • pts receiving linezolid or IV methylene blue

Preg Cat C

BBW: Suicidal thoughts

17
Q

Amitriptyline (Elavil)

  • MOA
  • Dosage
  • Adverse Events
  • is this normally prescribed for insomnia?
  • half life?
A

MOA:
-increases synaptic concentration of serotonin and NE in the CNS.

Dosage: 25-50mg at bedtime

Adverse effects:
-sedation, dizziness, HA, constipation, weight gain, confusion

Used off label for insomnia

Half life: 13-36hrs

18
Q

Amitryptyline (Elavil)

  • CI
  • Preg Cat
  • BBW
A

CI:

  • history of MI
  • MAOI

Preg Cat C

BBW: Suicidal thoughts

19
Q

Melatonin Agonists:

  • drugs
  • MOA
  • Dosage
  • Adverse events
  • good for what type of insomnia?
  • onset and half life
  • CI
  • Preg category
A

DrugS:
-Ramelteon (Rozerem)

MOA: agonists of melatonin receptors

Dosage: 8mg daily within 30 min of bedtime

Adverse Events: somnolence, HA, fatigue, dizziness, nausea

Good for sleep onset insomnia

onset 30mins and halflife 1-2hrs

CI:
-Fluvoxamine (Luvox) (SSRI)

Preg Cat C

20
Q

Belsomra (Suvorexant)

  • drug class
  • MOA
  • dosage
  • used for what type of insomnia?
  • half life and onset
  • special instructions
A

Drug class: orexin receptor antagonists

MOA: blocks binding of wake-promoting neuropeptide orexin A and B.

Dosage: 10mg once daily within 30mins of bedtime

Used for sleep onset and sleep maintenance.

half life is 12 hrs onset is 30minutes

special instructions: dont take immediately after a meal, this suppresses its absorption.

21
Q

Belsomra (Suvorexant)

  • Adverse events
  • CI
  • Pregnancy Cat
A

Adverse events:
-drowsiness, HA, abnormal dreams, cough

CI: Narcolepsy

Preg Cat C.

22
Q

Narcolepsy

-which med is used first line? 2nd line?

A

first line: provigil (modafinil)

2nd line: Dextroamphetamine

23
Q

Provigil (Modafinil)

  • MOA
  • dose
  • Adverse Events
  • CI
  • Preg cat?
A

MOA: increases dopaminergic signaling

Dose; 100mg qAM, can titrate up to 300-400mg

Adverse events:
-HA, nausea, nervousness, dry mouth

CI: hypersensitivity

Preg Cat: C

24
Q

Dextroamphetamine:

  • MOA
  • Dose
  • SE
  • Preg Cat
  • BBW
  • special instructions
A

MOA: stimulates CNS activity, blocks reuptake and increases release of NE and dopamine

Dose: 10mg daily (can go up to 60mg daily in divided doses)

SE: HTN, anorexia, addiction

Preg Cat C

BBW: high abuse potential, cardiac events

Special instructions: dont use late in evening for risk of insomnia

25
Q 
REM SLeep behavior disorder:
-meds
-MOA 
-dose 
-SE
-
A

Med: Melatonin

MOA: prepares body for sleep

Dose: 0.5-10mg qhs

SE:

  • abnormal heartbeat
  • dizziness
  • fatigue
26
Q

Movement Disorder; RLS and periodic limb movement disorders:
-what are the classes and their associated medications?

A

Dopaminergic agents: Sinemet

Dopamine agonists: Mirapex, requip, neupro

Anticonvulsants: Neurontin

27
Q

Sinemet

  • dosage
  • adverse events
  • MC uses
A

dose: Carbidopa 25mg/levodopa 100mg

adverse events: sleepiness, GI problems

28
Q

Dopamine Agonists:

  • MOA
  • used first line for what?
  • dosage
  • adverse events
  • pregnancy cat?
A

MOA: stimulates dopamine receptors

Used first line for movement disorders.

Dosages:

  • mirapex: 0.125 once daily 2-3hrs before bed
  • Requip: 0.25mg once daily 1-3hrs before bed
  • Neupro: apply 1mg patch daily

Adverse Events: nausea, lightheadedness

Preg Cat C

29
Q

Anticonvulsants:

  • meds
  • MOA
  • dosage
  • Adverse events
  • pregancy cat
  • is this usually used for RLS?
A

Med:
-Gabapentin (neurontin)

MOA:
-reduce presynaptic GABA release

Dosage: 300mg daily 2 hrs before bed

Adverse events:
-fatigue, dizziness, blurred vision

Preg Cat C

Used off label for RLS

Psych (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions