NUR 547 WEEK 4 LATEST
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
Sedating Antidepressants - ANSWERS--Certain serotonergic agents are used for
insomnia and may be an appealing option in clients with concurrent depression
• trazodone (Desyrel)
• amitriptyline (Elavil)
• mirtazapine (Remeron)
-agents may be prescribed as an adjunct to offset the stimulating effects of other
antidepressants
-Common Adverse Effects: Sedation, Anticholinergic effects, Weight gain,
Daytime sleepiness, Dizziness, Dry mouth
-Precautions: Hepatic impairment, Cardiac impairment, Hypertension, Older adults
QUESTION 2
Z-Drugs - ANSWERS-Sedative/hypnotic drugs, or z-drugs
-act on the brain to produce a calming effect
-may be prescribed to help clients who are unable to fall asleep as well as those
who have difficulty maintaining sleep or returning to sleep once awake
-bind to benzodiazepine sites on GABA receptors
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, NUR 547 WEEK 4 LATEST
-First-line agents for insomnia include:
• zolpidem (Ambien)
• zaleplon (Sonata)
• eszopiclone (Lunesta)
-Drugs may increase suicidal ideations.
QUESTION 3
Benzodiazepines - ANSWERS-approved for use with insomnia
-not considered a first-line treatment due to the potential for misuse
• when first-line agents fail, benzodiazepines may be used with caution for
insomnia.
QUESTION 4
Narcolepsy and Excessive Daytime Sleepiness - ANSWERS-currently no cure for
narcolepsy
-wake-promoting substances such as modafinil or armodafinil or stimulants such as
amphetamines and their derivatives are sometimes used
• Other meds for excessive sleepiness & sedation from obstructive sleep apnea,
narcolepsy, shift work, and non-24-hour sleep-wake disorder include sodium
oxybate and tasimelteon
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PAGE
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, NUR 547 WEEK 4 LATEST
*"Wake-promoting" agents have a risk for abuse
QUESTION 5
armodafinil (Nuvigil) - ANSWERS-FDA Indications:
-excessive sleepiness (OSA, narcolepsy, shift-work)
RX Status: Schedule IV
Normal Dosage: 150-250 mg/daily
QUESTION 6
modanifil (Provigil) - ANSWERS-FDA Indications:
-excessive sleepiness (OSA, narcolepsy, shift-work)
RX Status: Schedule IV
Normal Dosage: 150-400mg/daily
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, NUR 547 WEEK 4 LATEST
QUESTION 7
sodium oxybate (Xyrem) - ANSWERS-FDA Indications:
-narcolepsy with cataplexy and excessive daytime sedation
RX Status: Schedule III
Normal Dosage: 6-9g/night
QUESTION 8
tasimelteon (Hetlioz) - ANSWERS-FDA Indications:
-Non-24-hour sleep-wake disorder (often with blindness)
RX Status: not controlled
Normal Dosgae: 20 mg/night
END OF
PAGE
4
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
Sedating Antidepressants - ANSWERS--Certain serotonergic agents are used for
insomnia and may be an appealing option in clients with concurrent depression
• trazodone (Desyrel)
• amitriptyline (Elavil)
• mirtazapine (Remeron)
-agents may be prescribed as an adjunct to offset the stimulating effects of other
antidepressants
-Common Adverse Effects: Sedation, Anticholinergic effects, Weight gain,
Daytime sleepiness, Dizziness, Dry mouth
-Precautions: Hepatic impairment, Cardiac impairment, Hypertension, Older adults
QUESTION 2
Z-Drugs - ANSWERS-Sedative/hypnotic drugs, or z-drugs
-act on the brain to produce a calming effect
-may be prescribed to help clients who are unable to fall asleep as well as those
who have difficulty maintaining sleep or returning to sleep once awake
-bind to benzodiazepine sites on GABA receptors
END OF
PAGE
1
, NUR 547 WEEK 4 LATEST
-First-line agents for insomnia include:
• zolpidem (Ambien)
• zaleplon (Sonata)
• eszopiclone (Lunesta)
-Drugs may increase suicidal ideations.
QUESTION 3
Benzodiazepines - ANSWERS-approved for use with insomnia
-not considered a first-line treatment due to the potential for misuse
• when first-line agents fail, benzodiazepines may be used with caution for
insomnia.
QUESTION 4
Narcolepsy and Excessive Daytime Sleepiness - ANSWERS-currently no cure for
narcolepsy
-wake-promoting substances such as modafinil or armodafinil or stimulants such as
amphetamines and their derivatives are sometimes used
• Other meds for excessive sleepiness & sedation from obstructive sleep apnea,
narcolepsy, shift work, and non-24-hour sleep-wake disorder include sodium
oxybate and tasimelteon
END OF
PAGE
2
, NUR 547 WEEK 4 LATEST
*"Wake-promoting" agents have a risk for abuse
QUESTION 5
armodafinil (Nuvigil) - ANSWERS-FDA Indications:
-excessive sleepiness (OSA, narcolepsy, shift-work)
RX Status: Schedule IV
Normal Dosage: 150-250 mg/daily
QUESTION 6
modanifil (Provigil) - ANSWERS-FDA Indications:
-excessive sleepiness (OSA, narcolepsy, shift-work)
RX Status: Schedule IV
Normal Dosage: 150-400mg/daily
END OF
PAGE
3
, NUR 547 WEEK 4 LATEST
QUESTION 7
sodium oxybate (Xyrem) - ANSWERS-FDA Indications:
-narcolepsy with cataplexy and excessive daytime sedation
RX Status: Schedule III
Normal Dosage: 6-9g/night
QUESTION 8
tasimelteon (Hetlioz) - ANSWERS-FDA Indications:
-Non-24-hour sleep-wake disorder (often with blindness)
RX Status: not controlled
Normal Dosgae: 20 mg/night
END OF
PAGE
4
