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12 Cards in this Set
- Front
- Back
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Duration of time for Short Term Insomnia vs. Chronic Insomnia
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Short term: Less than 3 weeks
Chronic: > 4 weeks AND impairing daily functions |
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First-line drugs for Insomnia
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Non-BZD, BZD Receptor Agonists:
- Zolpidem - Zalepon - Eszopicone |
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Mechanism of Non-BZD, BZD-Receptor Agonists
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Enhance binding of GABA to GABA-A receptor; since GABA is inhibitory, it has a calming effect
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Quickest onset drug in BZDRA class
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Zalepon -- onset 15-30 minutes
Great for waking up in middle of night and needing to return to sleep quickly |
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SE of BZDRAs
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Dizziness, drowsiness, diarrhea, abnormal behaviors (ie eating stick of butter in middle of night)
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Second-line drug for Insomnia
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Trazodone
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MOA of Trazodone
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Non-tricyclic, non-SSRI antidepressant; has antihistamine properties due to inhibition of 5-HT2 receptors
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What drug is used to help alleviate Fluoxetine-induced insomnia?
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Trazodone
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Alternative Therapies to Insomnia (not first or second line)
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- Ramelteon: melatonin-receptor angonist
- Mirtazapine: 5-HT2 receptor antagonist |
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Two important contraindications of Ramelteon
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- Concurrent use of Fluvoxamine (don't give together!)
- Hepatic disease |
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Is Ramelteon safe in elderly?
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Yes! Good for elderly patients
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SE of Mirtazapine
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Weight gain from stimulation of appetite
- Also drowsiness, dizziness, HA |
