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20 Cards in this Set
- Front
- Back
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A patient gave the pharmacist a prescription for Lunesta 1 mg, take one tablet as-needed for sleep. Which of the following is an appropriate generic substitution for Lunesta? Answer AZolpidem BZaleplon CDoxepin extended-release DRamelteon EEszopiclone |
EEszopiclone |
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Jerry is using tamsulosin, psyllium, atenolol, sertraline and latanoprost. He wishes to purchase over-the-counter diphenhydramine for sleep, as suggested by his physician. Choose the correct statements: (Select ALL that apply.) Answer AThis medication will cause excessive urination at night, making it more difficult to rest well. BThis medication can cause dry mouth. CThis medication can cause diarrhea. DThis medication will make it more difficult to urinate; it will worsen your prostate symptoms. EThis medication might slightly worsen constipation. |
BThis medication can cause dry mouth.
DThis medication will make it more difficult to urinate; it will worsen your prostate symptoms. EThis medication might slightly worsen constipation. |
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Beth uses Lunesta 1 mg for sleep. She tells the pharmacist that the medicine puts her to sleep, but she has difficulty staying asleep. The pharmacist should instruct the patient as follows: Answer AShe should return to the doctor to have the medication changed because Lunesta is generally less effective than zolpidem. BShe should stop using the medicine as she has become addicted. CShe should stop using the medicine as she has developed pseudo-addiction. DShe should return to the doctor to have the medication changed because Lunesta is generally less effective than ramelteon. EShe should return to her doctor; it is likely that the dose will be increased. |
EShe should return to her doctor; it is likely that the dose will be increased. |
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Esther is a 55 year-old female who has been prescribed Ambien for sleep. She has one glass of wine at bedtime. Esther should receive the following counseling: Answer ALimit alcohol to one drink nightly. BLimit alcohol to two drinks nightly. CDo not use alcohol with any sleep medicine. DIt is best to drink mixed alcoholic drinks instead of wine. EIt is best to drink beer instead of wine.
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CDo not use alcohol with any sleep medicine. |
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The rationale behind avoiding benzodiazepines as sleep agents in the elderly is due to the following concerns: (Select ALLthat apply.) Answer AThe risk of falling and having injury. BThe risk of tachycardia and hypertensive crisis with chronic use. CThe risk of rebound hypertension. DCausing cognitive impairment. ERisk of physical (physiological) dependence and having to live dose-to-dose |
AThe risk of falling and having injury.
DCausing cognitive impairment. ERisk of physical (physiological) dependence and having to live dose-to-dose |
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Chandra cannot get to sleep. She lies in bed unable to sleep even though her favorite rock band is playing on the radio. She just came from the gym and feels as if she should be tired since she just had a good workout. Chandra just ate a hamburger and fries and says that a heavy meal usually makes her tired. What “sleep hygiene†suggestions could help Chandra fall asleep and have restful sleep? (Select ALL that apply.) Answer AKeep the bedroom dark, relatively quiet (perhaps peaceful music), and comfortable. BExercise prior to sleep (between 1-2 hours before bedtime) to exhaust yourself. CAvoid eating heavy meals before bedtime; digestion takes energy and a full meal can keep a person from sleeping well. DIf sleep does not seem possible (while lying in bed), get up and do something else for a short while. EDo not consume caffeine close to bedtime. |
AKeep the bedroom dark, relatively quiet (perhaps peaceful music), and comfortable.
CAvoid eating heavy meals before bedtime; digestion takes energy and a full meal can keep a person from sleeping well. DIf sleep does not seem possible (while lying in bed), get up and do something else for a short while. EDo not consume caffeine close to bedtime. |
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A patient at the pharmacy does not wish to purchase brand Sominex. He does not have enough money in his wallet. What can you recommend as a less expensive alternative that contains the same active ingredient? Answer ACetirizine BLoratadine CDiphenhydramine DDextromethorphan EPhenylephrine |
CDiphenhydramine |
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A pharmacist will instruct a medical resident about the medication Ambien. Which of the following statements regardingAmbien are correct? (Select ALL that apply.) Answer AThis medication comes in a tablet, a spray, a sublingual tab called Edluar and a sublingual formulation that is for night-time awakening called Intermezzo. BThe dosing for Intermezzo is 1.75 mg for males and 3.5 mg for females; take one SL tablet if you intend to sleep at least 2 more hours. CIn addition to somnolence, this type of medication can cause dizziness, ataxia and has a risk of parasomnias. However, the long-term safety is considered relatively fine. DLifestyle changes should be attempted prior to the use of prescription hypnotics. EDo not mix with alcohol. |
AThis medication comes in a tablet, a spray, a sublingual tab called Edluar and a sublingual formulation that is for night-time awakening called Intermezzo.
DLifestyle changes should be attempted prior to the use of prescription hypnotics. EDo not mix with alcohol. |
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A patient gave the pharmacist a prescription for Rozerem 8 mg tablets #15. Which of the following is an appropriate generic substitution for Rozerem? Answer AZolpidem BZaleplon CDoxepin extended-release DRamelteon EEszopiclone |
DRamelteon |
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Beth usually takes Lunesta prior to sleep. Last night, her husband took her out to dinner for her birthday. She brought home leftover fettuccini alfredo and birthday cake. She ate the leftovers with a glass of wine right before bed. When she took the Lunesta shortly afterwards, she found that she could not get to sleep for almost two hours. What was the most likely reason that the Lunesta did not help her get to sleep quickly? Answer AShe drank wine before bedtime. BShe got home later than usual. CShe had sugary foods in her stomach when she took the sleeping medicine. DShe had fatty food in her stomach when she took the sleeping medicine. EAny of the above could be possible reasons why she could not get to sleep. |
DShe had fatty food in her stomach when she took the sleeping medicine. |
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The zolpidem dose, along with the other non-benzodiazepines, must be lowered with concurrent use of these medications: (Select ALL that apply.) Answer AItraconazole BTrileptal CRitonavir DSaquinavir EErythromycin |
AItraconazole
CRitonavir DSaquinavir EErythromycin |
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Beth is a 46 year-old female who has been using Lunesta for sleep. Her other medications include lisinopril and a calcium plus vitamin D supplement. Her spouse complained that Beth had eaten his leftover birthday cake. Beth denied it. Cake crumbs were found in the bed and in Beth's teeth. What are likely reasons for the missing birthday cake? (Select ALL that apply.) Answer ABeth may have developed psychotic symptoms from an acute infection. BBeth may be experiencing the beginning of dementia of the Alzheimer's type. CBeth is being set-up by an angry spouse. DBeth got up at night and ate the cake but does not remember eating it. EBeth has experienced a parasomnia due to the use of Lunesta. |
DBeth got up at night and ate the cake but does not remember eating it. EBeth has experienced a parasomnia due to the use of Lunesta. |
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Several benzodiazepines are considered unsafe to use in elderly patients, and in many younger patients as well. Although all benzodiazepines carry health risks, these agents should be (especially) avoided in elderly patients and not used even for very short-term use. (Select ALL that apply.) Answer AQuazepam (Doral) BFlurazepam (Dalmane) CLorazepam (Ativan) DTriazolam (Halcion) ETemazepam
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AQuazepam (Doral) BFlurazepam (Dalmane)
DTriazolam (Halcion) |
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A patient has been using zolpidem 10 mg but wishes to switch to Ambien CR. What is the equivalent dose? Answer A11 mg B12.5 mg C15 mg D20 mg E25 mg |
B12.5 mg |
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Choose the correct statements regarding ramelteon: (Select ALL that apply.) Answer AIt is not controlled. BIt is considered safe to use long-term. CIt can be taken with fatty food and will work within an hour. DIt is more expensive than generic zolpidem, but works better. EThe brand name is Sonata. |
AIt is not controlled. BIt is considered safe to use long-term. |
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A patient gave the pharmacist a prescription for Ambien 10 mg, take one tablet by mouth before bedtime. Which of the following is an appropriate generic substitution for Ambien? Answer AZolpidem BZaleplon CDoxepin extended-release DRamelteon EEszopiclone
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AZolpidem |
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A pharmacist is discussing the use of sleep agents on medical rounds. Which of the following statements are correct? (Select ALL that apply.) Answer AThe non-benzodiazepines can increase the risk of death, even if used intermittently, due to issues such as difficulty breathing at night, increased risk of falls, infection and possibly cancer. BThese agents have minimal risks, if taken occasionally and not abused. CIntermezzo SL is a form of zolpidem that is useful for patients who wake up during the night and need to sleep at least four more hours. DThe non-benzodiazepines work by acting at the benzodiazapine receptor and acting as GABA agonists. ERamelteon is a melatonin receptor antagonist. |
AThe non-benzodiazepines can increase the risk of death, even if used intermittently, due to issues such as difficulty breathing at night, increased risk of falls, infection and possibly cancer.
CIntermezzo SL is a form of zolpidem that is useful for patients who wake up during the night and need to sleep at least four more hours. DThe non-benzodiazepines work by acting at the benzodiazapine receptor and acting as GABA agonists.
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Janice enters the pharmacy with a prescription for Lunesta. What is the controlled (DEA) category for Lunesta? Answer AC III BC IV CC V DC I EC II |
BC IV |
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In recent years it has been recognized that the use of the non-benzodiazepine agents such as zolpidem are not without risk. A warning has been added for this risk with the use of these agents: Answer APancreatitis BHepatic Failure CTeratogenicity DStevens-Johnson/TEN rash EIncreased mortality |
EIncreased mortality |
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Janice is a 70 year-old female. She is having difficulty sleeping since her cat died. She is not clinically depressed. She states she naps little during the day. The physician wishes to prescribe a hypnotic. Which is the most appropriate option? Answer ALorazepam BClonazepam CZolpidem DAlprazolam EDiazepam |
CZolpidem |
