Sleep OTT

Question 1

disease states associated with insomnia

Answer 1

anxiety, mood disorders

Question 2

medications associated with insomnia

Answer 2

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

Question 3

insomnia disorder is classified as

Answer 3

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

Question 4

first line therapy for sleep

Answer 4

sleep hygine principles

Question 5

most common sleep meds

Answer 5

z hypnotics - zolpidem, eszopiclone, zaleplon

Question 6

initial dose of zolpidem for women/elderly

Answer 6

5 mg (lower)

Question 7

which med has metallic taste

Answer 7

eszopiclone

Question 8

z hypnotics are _____ substrates

Answer 8

3A4

Question 9

z hypnotics side effects

Answer 9

somnolence, dizzy, ataxia, headache

Question 10

best benzo for sleeep

Answer 10

temazepam

Question 11

side effects benzos

Answer 11

drowsiness, dizzy, cognitive impairment, fall risk

Question 12

all medications approved FDA for sleep have what

Answer 12

sleep behaviors warning

Question 13

ramelteon is contraindicated with what drug

Answer 13

fluvoxamine

Question 14

ramelteon side effects

Answer 14

GI upset, next day somnolence, hyperprolacinemiat

Question 15

tasimelteon and ramelteon are ____ substrates

Answer 15

1A2

Question 16

orexin antagonists

Answer 16

suvorexant, lemborexant, daridorexant

Question 17

how much sleep should you get with orexin antagonists

Answer 17

at least 7 hours

Question 18

orexin -exants contraindication

Answer 18

narcolepsy

Question 19

orexin antagonists are ____substrates

Answer 19

3a4

Question 20

how does doxepin work

Answer 20

tricyclic antidepressant exerts effect through H1 histamine antagonism

Question 21

doxepin side effects

Answer 21

anticholinergic

Question 22

trazodone is ____ for insomnia

Answer 22

not FDA approvedt

Question 23

trazodone has a _____ halflife

Answer 23

long, next day hangover

Question 24

mirtazapine use

Answer 24

sleep agent for use in depression

Question 25

quetiapine for sleep ?

Answer 25

low dose not recommended unless comorbid psych disorder

Question 26

melatonin is a _____ substrate

Answer 26

1A2

Question 27

german chamomile consideration

Answer 27

allergic rxn in pts with daisy/ragweed allergy

Question 28

obstructive sleep apnea diagnosis

Answer 28

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

Question 29

obstructive sleep apnea symptoms

Answer 29

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

Question 30

if pts have insomnia and apenea what should be treated first

Answer 30

apnea

Question 31

when do we do polysomnography?

Answer 31

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

Question 32

treatments for sleep apnea

Answer 32

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

Question 33

medication for sleep apnea

Answer 33

CPAP modafanil armodafanil

Question 34

narcolepsy tetrad

Answer 34

excessive daytime sleepiness cataplexy (weakness) hallucinations sleep paralysis

Question 35

meds for cataplexy

Answer 35

sodium oxybate (Xyrem) Xywav Lumryz

Question 36

Xywav sodium content and age of use

Answer 36

low sodiun 7 and older

Question 37

Lumryz dosing and age

Answer 37

ER dosage form, once nightly dosing, adults only

Question 38

excessive daytime sleepiness treatment drugs

Answer 38

modafanil/armodafanil sodium oxybate pitolisant solriamfetol

Question 39

narcolepsy drugs with potential rash

Answer 39

modafanil, armodafanil

Question 40

pitolisant MOA

Answer 40

H3 antagonist, inverse agonist

Question 41

pitolisant contraindication

Answer 41

hepatic impairment

Question 42

pitolistant concert

Answer 42

QT interval

Question 43

pitolisant substrate and inducer

Answer 43

2D6/3A4 induces 3A4

Question 44

pitolistant caution with which drug

Answer 44

oral contraceptives, reduce efficacy of OCs

Question 45

what to avoid with pitolisant

Answer 45

OTC antihistamines H1 antagonists

Question 46

solriamfetol MOA

Answer 46

dopamine norepinephrine reuptake inhibitor

Question 47

avoid solriamfetol in what

Answer 47

CV disease, bipolar, psychosis,

Question 48

dosing of solriamfetol

Answer 48

start 37.5 max 75 renal: starting and max dose 37.5

Question 49

monitoring for solriamfetol

Answer 49

BP and HR, can increase

Question 50

treatment for wakefulness or night shift workers

Answer 50

modafanil, armodafanil

Question 51

when to take modafanil and armodafanil

Answer 51

1 hour before work period starts

Question 52

restless leg syndrome treatment

Answer 52

gabapentin enacarbil ropinerole, pramipexole iron supplementation