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PHRM 845 > Sleep OTT > Flashcards

Sleep OTT Flashcards

1
Q

disease states associated with insomnia

A

anxiety, mood disorders

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2
Q

medications associated with insomnia

A

caffeine, modafanil, amphetamines, beta agonists, beta blockers, nicotine, bupropion, decongestants, methyphenidate

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3
Q

insomnia disorder is classified as

A

difficulty with sleep initation, maintenance, or early awakening
at least 3 nights per week
for at least 3 months

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4
Q

first line therapy for sleep

A

sleep hygine principles

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5
Q

most common sleep meds

A

z hypnotics - zolpidem, eszopiclone, zaleplon

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6
Q

initial dose of zolpidem for women/elderly

A

5 mg (lower)

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7
Q

which med has metallic taste

A

eszopiclone

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8
Q

z hypnotics are _____ substrates

A

3A4

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9
Q

z hypnotics side effects

A

somnolence, dizzy, ataxia, headache

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10
Q

best benzo for sleeep

A

temazepam

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11
Q

side effects benzos

A

drowsiness, dizzy, cognitive impairment, fall risk

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12
Q

all medications approved FDA for sleep have what

A

sleep behaviors warning

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13
Q

ramelteon is contraindicated with what drug

A

fluvoxamine

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14
Q

ramelteon side effects

A

GI upset, next day somnolence, hyperprolacinemiat

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15
Q

tasimelteon and ramelteon are ____ substrates

A

1A2

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16
Q

orexin antagonists

A

suvorexant, lemborexant, daridorexant

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17
Q

how much sleep should you get with orexin antagonists

A

at least 7 hours

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18
Q

orexin -exants contraindication

A

narcolepsy

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19
Q

orexin antagonists are ____substrates

A

3a4

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20
Q

how does doxepin work

A

tricyclic antidepressant exerts effect through H1 histamine antagonism

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21
Q

doxepin side effects

A

anticholinergic

22
Q

trazodone is ____ for insomnia

A

not FDA approvedt

23
Q

trazodone has a _____ halflife

A

long, next day hangover

24
Q

mirtazapine use

A

sleep agent for use in depression

25
Q

quetiapine for sleep ?

A

low dose not recommended unless comorbid psych disorder

26
Q

melatonin is a _____ substrate

A

1A2

27
Q

german chamomile consideration

A

allergic rxn in pts with daisy/ragweed allergy

28
Q

obstructive sleep apnea diagnosis

A

at least 5 obstructive apneas per hour of sleep confirmed by polysomnography

29
Q

obstructive sleep apnea symptoms

A

excessive daytime sleepy
snoring
pauses in breaths
headache
irritability
sore throat
ED
GERD

30
Q

if pts have insomnia and apenea what should be treated first

A

apnea

31
Q

when do we do polysomnography?

A

cardiorespiratory disease
sleep related hypoventilation
chronic opioid medication use
hx stroke
severe insomnia

32
Q

treatments for sleep apnea

A

weight loss
smoking cessation
avoid alcohol/CNS depress
sleep on side

33
Q

medication for sleep apnea

A

CPAP
modafanil
armodafanil

34
Q

narcolepsy tetrad

A

excessive daytime sleepiness
cataplexy (weakness)
hallucinations
sleep paralysis

35
Q

meds for cataplexy

A

sodium oxybate (Xyrem)
Xywav
Lumryz

36
Q

Xywav sodium content and age of use

A

low sodiun
7 and older

37
Q

Lumryz dosing and age

A

ER dosage form, once nightly dosing, adults only

38
Q

excessive daytime sleepiness treatment drugs

A

modafanil/armodafanil
sodium oxybate
pitolisant
solriamfetol

39
Q

narcolepsy drugs with potential rash

A

modafanil, armodafanil

40
Q

pitolisant MOA

A

H3 antagonist, inverse agonist

41
Q

pitolisant contraindication

A

hepatic impairment

42
Q

pitolistant concert

A

QT interval

43
Q

pitolisant substrate and inducer

A

2D6/3A4
induces 3A4

44
Q

pitolistant caution with which drug

A

oral contraceptives, reduce efficacy of OCs

45
Q

what to avoid with pitolisant

A

OTC antihistamines
H1 antagonists

46
Q

solriamfetol MOA

A

dopamine norepinephrine reuptake inhibitor

47
Q

avoid solriamfetol in what

A

CV disease, bipolar, psychosis,

48
Q

dosing of solriamfetol

A

start 37.5 max 75
renal: starting and max dose 37.5

49
Q

monitoring for solriamfetol

A

BP and HR, can increase

50
Q

treatment for wakefulness or night shift workers

A

modafanil, armodafanil

51
Q

when to take modafanil and armodafanil

A

1 hour before work period starts

52
Q

restless leg syndrome treatment

A

gabapentin enacarbil
ropinerole, pramipexole
iron supplementation

PHRM 845 (32 decks)

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