Summer E1 Neuro Sleep Disorders

Question 1

Sleep disorders -

Narcolepsy, Daytime sleepiness med classes and meds

Answer 1

Wake aids that activate CNS“-afinil”

Modafinil, Armodafinil

Question 2

Sleep disorders -

Insomnia med classes and meds

Answer 2

Non-BenZodiazepine R Agonists“the Z’s”: Zolpidem, EsZopiclone, Zaleplon (BZs not commonly used d/t abuse/dependency)

Sedating Antidepressants (5) **Trazadone, Amitriptyline, Mirtazapine, Nefazadone, Doxepin

OTC Diphenhydramine, Melatonin

Other Ramelton, Suvorexant

Question 3

Non-BenZodiazapine R Agonist

MOA

Answer 3

Occupy benzo R site on GABA, cause ↑GABA (inhibitory NT) promoting sleepiness

Question 4

Non-BenZodiazapine R Agonist

AE

Answer 4

Residual SEDATION/grogginess, Psychomotor impairment

Rebound INSOMNIA if withdraw abruptly

Anterograde AMNESIA

Question 5

Non-BenZodiazepine R Agonist

Pt Instructions

Answer 5

Take at bedtime

Avoid driving after

Must TAPER OFF if withdrawing

Question 6

Trazadone

AEs

Answer 6

hypotension, dizziness

(*caution w HEART disease, HTN, CV drugs)

Question 7

Mirtazapine

AE

Answer 7

Daytime sedation, drowiness

Wt Gain

Question 8

Doxepin

good for who?

Answer 8

Older person

Question 9

Melatonin

• MOA*
• AE*
• Interactions*

Answer 9

MOA: ↑activity of GABA,

regulate circadian rhythm, endocrine secretions, sleep patterns

• Low AE*
• Some interactions*

Question 10

Ramelteon

Benefit

Answer 10

Not a controlled substance

Question 11

Suvorexant

MOA

Answer 11

Turns off wakefulness mechanisms