12988364
Descripción
Test por Maggie Throckmorton, actualizado hace más de 1 año
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Creado por Maggie Throckmorton
hace más de 6 años
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Pregunta 1
Pregunta
All of the following are true about Trazadone (Desyrel, Olpetro) (select all that apply):
Respuesta
-
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
Pregunta 2
Pregunta
Which Schedule IV medication is FDA approved for sleep onset and maintenance?
Respuesta
-
Doxepin (Silenor, Sinequan)
-
Suvorexant (Belsomra)
-
Quetiapine (Seroquel)
-
Trazadone (Desyrel, Olpetro)
Pregunta 3
Pregunta
Suvorexant (Belsomra) is an Orexin 1 and 2 [blank_start]antagonist[blank_end] and is not recommended if a patient is on a strong [blank_start]CYP3A4[blank_end] [blank_start]inhibitor[blank_end] like nefazodone, suboxone, clarithromycin and certain HIV medications.
Respuesta
-
antagonist
-
agonist
-
CYP3A4
-
CYP2D6
-
inhibitor
-
inducer
Pregunta 4
Pregunta
Which brand name of Doxepin is used for sleep?
Respuesta
-
Silenor
-
Sinequan
Pregunta 5
Pregunta
Doxepin (Silenor) is a selective and potent [blank_start]Histamine[blank_end] 1 antagonist, that is used for sleep [blank_start]maintenance[blank_end] insomnia, and is the only [blank_start]non-controlled[blank_end] prescribed for sleep maintenance insomnia.
Respuesta
-
Histamine
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Orexin
-
maintenance
-
onset
-
non-controlled
-
controlled
Pregunta 6
Pregunta
There is an increased risk for sedation with higher or lower doses of Doxepin (Silenor)?
Respuesta
-
Higher
-
Lower
Pregunta 7
Pregunta
T or F. Weight gain is unusual for low dose Sinequan (Doxepin).
Respuesta
- True
- False
Pregunta 8
Pregunta
The following are common and uncommon side effects for Doxepine (Silenor) (select all that apply):
Respuesta
-
Sweating
-
Fatigue
-
Paralytic illeus
-
EPS
-
QTc prolongation
-
Hair loss
Pregunta 9
Pregunta
Which medication can increase doxepin concentrations?
Respuesta
-
Depakote
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ASA
-
Haldol
-
Lisinipril
Pregunta 10
Pregunta
[blank_start]Temazepam[blank_end] is also known as Restoril and is a [blank_start]benzodiazepine[blank_end] that is FDA approved for the [blank_start]short[blank_end]-term treatment of insomnia. It has a BBW of increased CNS depressant effects with [blank_start]opioids[blank_end].
Respuesta
-
Temazepam
-
Alprazolam
-
benzodiazepine
-
anti-convulsant
-
short
-
long
-
opioids
-
MAOi's
Pregunta 11
Pregunta
T or F. Temazepam may be more effective for mid-nocturnal awakenings than sleep onset insomnia.
Respuesta
- True
- False
Pregunta 12
Pregunta
Temazepam or Restoril should be dosed how soon before bedtime?
Respuesta
-
1-2 hours
-
3-4 hours
-
5-7 hours
-
30 minutes to an hour
Pregunta 13
Pregunta
The following is correct about Temazepam (Restoril) (select all that apply):
Respuesta
-
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
Pregunta 14
Pregunta
Which benzodiazepine used for sleep is more likely to cause anterograde amnesia, unusual behaviors and hallucinations.
Respuesta
-
Temazepam (Restoril)
-
Trialzolam (Halcion)
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Zolpidem (Ambien)
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Clonazepam (Klonopin)
Pregunta 15
Pregunta
[blank_start]Triazolam[blank_end] or Halcion is FDA approved for short-term insomnia but can be used in [blank_start]catatonia[blank_end]. The shorter half-life prevents [blank_start]sedation[blank_end] and may minimize interactions with daytime meds. [blank_start]Ranitidine[blank_end] may increase concentrations.
Respuesta
-
Triazolam
-
Temazepam
-
catatonia
-
depression
-
sedation
-
addiction
-
Ranitidine
-
Omeprazole
Pregunta 16
Pregunta
T or F. With Triazolam the clearance is slightly faster with women than men.
Respuesta
- True
- False
Pregunta 17
Pregunta
The following is correct about Zaleplon (Sonata)
Respuesta
-
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
Pregunta 18
Pregunta
This medication can reduce the effectiveness of Zaleplon (Sonata).
Respuesta
-
Carbamazepine (Tegretol)
-
Fluoxetine (Prozac)
-
Levofloxacin (Levaquin)
-
Acetiminophen
Pregunta 19
Pregunta
This is a uncommon side effect of Zaleplon (Sonata).
Respuesta
-
Angioedema
-
Sedation
-
Ataxia
-
Reduced Appetit
Pregunta 20
Pregunta
Zaleplon (Sonata) has not been shown to [blank_start]increase[blank_end] total sleep time or decrease the number of [blank_start]awakenings[blank_end].
Respuesta
-
increase
-
decrease
-
awakenings
-
dreams
Pregunta 21
Pregunta
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.
Respuesta
- True
- False
Pregunta 22
Pregunta
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?
Respuesta
-
Eszopiclone (Lunesta)
-
Zolpidem (Ambien)
-
Trazadone (Desyeral)
-
Tamazepam (Restoril)
Pregunta 23
Pregunta
The following is true about Eszopiclone (Lunesta) (select all that apply):
Respuesta
-
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
Pregunta 24
Pregunta
Which baseline and routine labs are required with Eszopiclone (Lunesta)?
Respuesta
-
CMP, CBC. TSH
-
LFT, BUN, CrCl
-
None
-
ALT, AST, GGT
Pregunta 25
Pregunta
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).
Respuesta
- True
- False
Pregunta 26
Pregunta
The FDA recommends avoiding this activity the whole day after taking Ambien CR.
Respuesta
-
Driving
-
Farming
-
Yoga
-
Trampoline Jumping
Pregunta 27
Pregunta
What formulation of Zolpidem can be used for nocturnal awakenings with difficulty falling back asleep, with at least 4 hours of bedtime remaining.
Respuesta
-
Edular
-
Intermezzo
-
Ambien CR
-
Zolpimist
Pregunta 28
Pregunta
Women and the elderly metabolize zolpidem more [blank_start]slowly[blank_end] than men, making them more vulnerable to [blank_start]next day[blank_end] effects. As such the max dose for women and the elderly is [blank_start]5[blank_end]mg.
Respuesta
-
slowly
-
quickly
-
next day
-
same day
-
5
-
8
Pregunta 29
Pregunta
T or F. Ambien CR may allow enough agent to remain at receptors to improve sleep time and prevent early morning awakenings.
Respuesta
- True
- False
Pregunta 30
Pregunta
[blank_start]Zolpidem[blank_end] has been shown to increase total [blank_start]sleep[blank_end] time and [blank_start]reduce[blank_end] the number of mid-nocturnal awakenings.
Respuesta
-
Zolpidem
-
Sonata
-
sleep
-
wake
-
reduce
-
increase
Pregunta 31
Pregunta
Quetiapine (Seroquel) is used off-label for [blank_start]insomnia[blank_end] and is best for [blank_start]insomnia[blank_end] in patients with a co-occurring psychiatric illness. There are significant [blank_start]metabolic[blank_end] side effects and a risk for [blank_start]QTc prolongation[blank_end].
Respuesta
-
insomnia
-
sleep maintenance
-
insomnia
-
sleep maintenance
-
metabolic
-
anti-cholinergic
-
QTc prolongation
-
Stevens-Johnson Syndrome
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