Maggie Throckmorton
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Quiz on Sleep Medications in Psychiatry, created by Maggie Throckmorton on 03/24/2018.

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Maggie Throckmorton
Created by Maggie Throckmorton about 6 years ago
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Sleep Medications in Psychiatry

Sleep Medications in Psychiatry

Question 1 of 31

1

All of the following are true about Trazadone (Desyrel, Olpetro) (select all that apply):

Select one or more of the following:

  • Blocks SERT

  • 5HT2A antagonism

  • Is really a poor anti-depressant that is used off-label for insomnia

  • Has a rare but serious side effect of priapism

  • Requires a baseline CMP in all patients before initiating

  • Is recommended by the AASM for sleep onset or maintenance insomnia

Explanation

Question 2 of 31

1

Which Schedule IV medication is FDA approved for sleep onset and maintenance?

Select one of the following:

  • Doxepin (Silenor, Sinequan)

  • Suvorexant (Belsomra)

  • Quetiapine (Seroquel)

  • Trazadone (Desyrel, Olpetro)

Explanation

Question 3 of 31

1

Select from the dropdown lists to complete the text.

Suvorexant (Belsomra) is an Orexin 1 and 2 ( antagonist, agonist ) and is not recommended if a patient is on a strong ( CYP3A4, CYP2D6 ) ( inhibitor, inducer ) like nefazodone, suboxone, clarithromycin and certain HIV medications.

Explanation

Question 4 of 31

1

Which brand name of Doxepin is used for sleep?

Select one of the following:

  • Silenor

  • Sinequan

Explanation

Question 5 of 31

1

Doxepin (Silenor) is a selective and potent 1 antagonist, that is used for sleep insomnia, and is the only prescribed for sleep maintenance insomnia.

Drag and drop to complete the text.

    Histamine
    Orexin
    maintenance
    onset
    non-controlled
    controlled

Explanation

Question 6 of 31

1

There is an increased risk for sedation with higher or lower doses of Doxepin (Silenor)?

Select one of the following:

  • Higher

  • Lower

Explanation

Question 7 of 31

1

T or F. Weight gain is unusual for low dose Sinequan (Doxepin).

Select one of the following:

  • True
  • False

Explanation

Question 8 of 31

1

The following are common and uncommon side effects for Doxepine (Silenor) (select all that apply):

Select one or more of the following:

  • Sweating

  • Fatigue

  • Paralytic illeus

  • EPS

  • QTc prolongation

  • Hair loss

Explanation

Question 9 of 31

1

Which medication can increase doxepin concentrations?

Select one of the following:

  • Depakote

  • ASA

  • Haldol

  • Lisinipril

Explanation

Question 10 of 31

1

is also known as Restoril and is a that is FDA approved for the -term treatment of insomnia. It has a BBW of increased CNS depressant effects with .

Drag and drop to complete the text.

    Temazepam
    Alprazolam
    benzodiazepine
    anti-convulsant
    short
    long
    opioids
    MAOi's

Explanation

Question 11 of 31

1

T or F. Temazepam may be more effective for mid-nocturnal awakenings than sleep onset insomnia.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 31

1

Temazepam or Restoril should be dosed how soon before bedtime?

Select one of the following:

  • 1-2 hours

  • 3-4 hours

  • 5-7 hours

  • 30 minutes to an hour

Explanation

Question 13 of 31

1

The following is correct about Temazepam (Restoril) (select all that apply):

Select one or more of the following:

  • Can cause withdrawal symptoms when stopped suddenly

  • Elderly patients need a lower dose

  • Does not require any baseline labs in patients with co-morbid illness

  • Can cause retrograde amnesia

Explanation

Question 14 of 31

1

Which benzodiazepine used for sleep is more likely to cause anterograde amnesia, unusual behaviors and hallucinations.

Select one of the following:

  • Temazepam (Restoril)

  • Trialzolam (Halcion)

  • Zolpidem (Ambien)

  • Clonazepam (Klonopin)

Explanation

Question 15 of 31

1

or Halcion is FDA approved for short-term insomnia but can be used in . The shorter half-life prevents and may minimize interactions with daytime meds. may increase concentrations.

Drag and drop to complete the text.

    Triazolam
    Temazepam
    catatonia
    depression
    sedation
    addiction
    Ranitidine
    Omeprazole

Explanation

Question 16 of 31

1

T or F. With Triazolam the clearance is slightly faster with women than men.

Select one of the following:

  • True
  • False

Explanation

Question 17 of 31

1

The following is correct about Zaleplon (Sonata)

Select one or more of the following:

  • Is also a Hyundai car model

  • Is FDA approved for short-term insomnia

  • Is recommended by the AASM for sleep onset insomnia

  • May have more side effects due to the short half-life

  • A high-fat meal will delay absorption and decrease beneficial effects

  • May cause more dependence than some other sedative hypnotics-especially in those without a substance abuse history

Explanation

Question 18 of 31

1

This medication can reduce the effectiveness of Zaleplon (Sonata).

Select one of the following:

  • Carbamazepine (Tegretol)

  • Fluoxetine (Prozac)

  • Levofloxacin (Levaquin)

  • Acetiminophen

Explanation

Question 19 of 31

1

This is a uncommon side effect of Zaleplon (Sonata).

Select one of the following:

  • Angioedema

  • Sedation

  • Ataxia

  • Reduced Appetit

Explanation

Question 20 of 31

1

Select from the dropdown lists to complete the text.

Zaleplon (Sonata) has not been shown to ( increase, decrease ) total sleep time or decrease the number of ( awakenings, dreams ).

Explanation

Question 21 of 31

1

T or F. Zaleplon can be used for mid-nocturnal awakenings with 4 hrs of sleep time remaining because evidence shows no residual sedation after 4 hours.

Select one of the following:

  • True
  • False

Explanation

Question 22 of 31

1

Jerry is a 38-year-old male who struggled with insomnia for several months. After trials of medication for short-term insomnia he wants to explore a medication that has efficacy for long term us and has a low potential for abuse. Based on this patient's wishes, which medication should the PMHNP prescribe?

Select one of the following:

  • Eszopiclone (Lunesta)

  • Zolpidem (Ambien)

  • Trazadone (Desyeral)

  • Tamazepam (Restoril)

Explanation

Question 23 of 31

1

The following is true about Eszopiclone (Lunesta) (select all that apply):

Select one or more of the following:

  • AASM recommends for both sleep onset and maintenance insomnia

  • Can cause an unpleasant taste as a side effect

  • Should be taken with a high-fat meal

  • Titration is required

  • Rifampin decreases levels

Explanation

Question 24 of 31

1

Which baseline and routine labs are required with Eszopiclone (Lunesta)?

Select one of the following:

  • CMP, CBC. TSH

  • LFT, BUN, CrCl

  • None

  • ALT, AST, GGT

Explanation

Question 25 of 31

1

T or F. Sally has a history of a substance use disorder. She has been sober from drugs and alcohol for 5 years. She is now experiencing a period of insomnia. It is best practice for the PMHNP to prescribe Zolpidem (Ambien).

Select one of the following:

  • True
  • False

Explanation

Question 26 of 31

1

The FDA recommends avoiding this activity the whole day after taking Ambien CR.

Select one of the following:

  • Driving

  • Farming

  • Yoga

  • Trampoline Jumping

Explanation

Question 27 of 31

1

What formulation of Zolpidem can be used for nocturnal awakenings with difficulty falling back asleep, with at least 4 hours of bedtime remaining.

Select one of the following:

  • Edular

  • Intermezzo

  • Ambien CR

  • Zolpimist

Explanation

Question 28 of 31

1

Women and the elderly metabolize zolpidem more than men, making them more vulnerable to effects. As such the max dose for women and the elderly is mg.

Drag and drop to complete the text.

    slowly
    quickly
    next day
    same day
    5
    8

Explanation

Question 29 of 31

1

T or F. Ambien CR may allow enough agent to remain at receptors to improve sleep time and prevent early morning awakenings.

Select one of the following:

  • True
  • False

Explanation

Question 30 of 31

1

Select from the dropdown lists to complete the text.

( Zolpidem, Sonata ) has been shown to increase total ( sleep, wake ) time and ( reduce, increase ) the number of mid-nocturnal awakenings.

Explanation

Question 31 of 31

1

Select from the dropdown lists to complete the text.

Quetiapine (Seroquel) is used off-label for ( insomnia, sleep maintenance ) and is best for ( insomnia, sleep maintenance ) in patients with a co-occurring psychiatric illness. There are significant ( metabolic, anti-cholinergic ) side effects and a risk for ( QTc prolongation, Stevens-Johnson Syndrome ).

Explanation

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