NU643 Exam Questions with All Correct Answers
Shift workers excessive daytime sleepiness - Answer- Modafinil (Provigil) - FDA approved for narcolepsy
- Stimulant effect w/o the BP and cardiac issues
Untreated insomnia and depressive episodes - Answer- Untreated insomnia can make it harder t...
Shift workers excessive daytime sleepiness - Answer- Modafinil (Provigil) - FDA
approved for narcolepsy
- Stimulant effect w/o the BP and cardiac issues
Untreated insomnia and depressive episodes - Answer- Untreated insomnia can make it
harder to recover from a depressive episode
Must treat insomnia along with depressive/anxiety
Can persist after depressive symptoms are better..
Can be present before depressive episode and linger after being treated...
Can present before a depressive episode occurs
Sleep hygiene practices/Carlat Psychiatry - Answer- Avoid caffiene,
Sleep schedule
Avoid blue light,
Remove electronic 1hr b/f bed
CBT - Insomnia - form of CBT specifically for sleep... .
Avoid exercise 3-4 hours b/f bed
No napping, sleep and wake at same time.
When are they taking their meds....take meds at the right time
Clonidine and propranolol - Answer- To tx physical response - decreased BP, HR -
monitor VS for safety
To reduce risk of falls, syncope issues when your BP or HR get low.
Typically used during the day...avoid at night to minimize risk of hypotension.
Avoid with eating DO as hydration can be an issue
sedative-hypnotics to treat insomnia - Answer- Zolpidem (Ambien) - 1st nonBZ - sleep
eating, sleep driving, sleep gambling, sleep sex, sleep complex behaviors
Zaleplon (Sonata)
Eszopiclone (Lunesta)
Zolpidem XR (Ambien CR)
Zolpidem ODT (Edluar)
Zolpimist, A LOT of PT EDUCATION - bc of complex behaviors
Amygdala - Answer- controls anxiety/fear/worry - anxiety d/o, phobias, PTSD, result
from malfunctions w/n these circuits. Flight or fight - motor response - PAG
(periaqueductal gray) located in brain stem
, Locus Coeruleus - Answer- Home of noradrenergic cell bodies
Autonomic response
Inc BP, Inc HR, Inc RR,
- Prolonged activation = inc risk of atherosclerosis, MI, CAD, Stroke,
fear amygdala. - Answer- Motor response = brain stem(periaqueductal gray) - fight or
flight
Endocrine response = hypothalamus
Fear conditioning - Answer- associate feat with neutral stimulus
VMPFC and hippocampus info passes to amygdala
Amygdala can remember stimuli w/ glutamate transmission
Glutamate - Answer- inhibitory stimuli
conditioned-fear response - Answer- Memories do not get erased but can be rewired
Anxiety can be suppressed but IS NOT REMOVED ENTIRELY
Fear extinction - Answer- progressive reduction of response to stimuli to reduce
symptoms
first-line treatment for GAD - Answer- SSRIs, SNRIs
d/t prolonged effectivness - BZ can be used for acute symptoms until effective
Buspar (serotonin) - Answer- 5HT1a affects - Post synaptincally - decreases 5HT
activity-
Can help with relaxation - FDA for GAD
Buspirone/anxiety D/O - Answer- GAD - indicated GAD
Used in other type in practice...but FDA indicated in
SSRI/SNRI - Answer- Zoloft,
paxil, prozac - not mentioned in discussion but is also used for anxiety as well as MDD
hydroxyzine - Answer- 1. alcohol dependence and anxiety disorder.
Antihistamine affect
Calms withdrawal s/s in ETOH dependence, insomnia, and anxiety
Can be used short term - use like you use BZ - gradual taper
short- and long-acting benzodiazepine risk - Answer- LT use - increase risk of dementia
- on long acting - valium more strongly associated with dementia.
Beer's Criteria - avoid prescribing Long acting, long term use to minimize dementia
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