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.

Select option below to complete the highlighted 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 ❌.

Select option below to complete the highlighted 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.

Select option below to complete the highlighted 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.

Select option below to complete the highlighted 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 ).

	Created by Maggie Throckmorton over 6 years ago

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

Sleep Medications in Psychiatry

Sleep Medications in Psychiatry

Question 1 of 31

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

Select one or more of the following:

Explanation

Question 2 of 31

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

Select one of the following:

Explanation

Question 3 of 31

Select from the dropdown lists to complete the text.

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

Explanation

Question 4 of 31

Which brand name of Doxepin is used for sleep?

Select one of the following:

Explanation

Question 5 of 31

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

Select option below to complete the highlighted text

Explanation

Question 6 of 31

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

Select one of the following:

Explanation

Question 7 of 31

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

Select one of the following:

Explanation

Question 8 of 31

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

Select one or more of the following:

Explanation

Question 9 of 31

Which medication can increase doxepin concentrations?

Select one of the following:

Explanation

Question 10 of 31

❌ 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 ❌.

Select option below to complete the highlighted text

Explanation

Question 11 of 31

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

Select one of the following:

Explanation

Question 12 of 31

Temazepam or Restoril should be dosed how soon before bedtime?

Select one of the following:

Explanation

Question 13 of 31

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

Select one or more of the following:

Explanation

Question 14 of 31

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

Select one of the following:

Explanation

Question 15 of 31

❌ 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.

Select option below to complete the highlighted text

Explanation

Question 16 of 31

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

Select one of the following:

Explanation

Question 17 of 31

The following is correct about Zaleplon (Sonata)

Select one or more of the following:

Explanation

Question 18 of 31

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

Select one of the following:

Explanation

Question 19 of 31

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

Select one of the following:

Explanation

Question 20 of 31

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.

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

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