Anxiety Flashcards
Apart from anxiety, what else are benzodiazepines used for
Epilepsy
6 functions of hypnotics and anxiolytics
Relief of anxiety states Induction of sleep Sedation and amnesia Control of withdrawal states Muscle relaxation Severe behaviour disturbances
What is the master regulator of the sleep wake cycle
Suprachiasmatic nucleus
Where is the suprachiasmatic nucleus
Hypothalamus
When do neurones in the suprachiasmatic nucleus increase their activity
During the light phase (awake)
What hormone increases during dark phase
Melatonin
Projections from which 3 cell groups are under the control of the suprachiasmatic nucleus
Cells of raphe
Tuberomammilary nucleus
Ventrolateral preoptic nucleus
What systems are involved in wakefullness
Cholinergic systems and monaminergic projections
What nuclei are involved in cholinergic systems involved in wakefullness
Pedunculopontine nucleus
Laterodorsal tegmental nucleus
What areas of the brain are in the monoaminergic projections involved in wakefullness
Locus coeruleus
Raphe nuclei
Tuberomamillary nucleus
What neurones are involved in sleep
GABA and galanin neurones
What molecules promote sleep
GABA
Melatonin
Adenosine
What molecules maintain wakefullness
Noradrenaline Dopamine Serotonin Histamine Orexin Ach
Define the following
a) REM sleep
b) NREM sleeo
c) slow wave sleeo
a) random eye movement sleep
b) non random eye movement sleeo
c) 4 stages of REM
Which gene expression change leads us to believe that memory consolidation is a purpose of sleep
Zif 68
What is transient insomnia
Due to jet lag
What is chronic insomina
> 3 weeks
3 possible causes of short term insomnia
Bereavement
Illness
Stress
What 2 categories of drugs are currently used in sleep disorders
Benzodiazepines
Z drugs
Which 2 benzodiazepines are used for short term insomnia
Lorazepam and ternazepam
What benzodiazepine is used in chronic insomnia
Eszopidone
What z drug is used to treat chronic insomnia
extended release zolpidem
Name 3 z drugs
Zaleplon
Zolpidem
Zopiclone
Are the half lives of Z drugs long or short
short
Name 5 unwanted side effects of benzodiazepines
Changes in sleep patterns Daytime sedation Rebound insomnia Tolerance Dependence
Mechanism of action of pregabalin
Binds to alpha 2 delta subunit of voltage gated calcium channels
Where is orexin produced
Hypothalamus
Another name for orexin
Hypocretin
2 forms of orexin
Orexin A and orexin B
What mediates the effects of orexin
OX1 and OX2 receptors
What does orexin mediate
Arousal, appetite and wakefullness
What illness is associated with an orexin deficiency
Narcolepsy
How can the orexin system be targeted to treat insomnia
Orexin antagonists can treat it
Changes seen in the limbic system in an anxiety disorder
Hyperactivity
State 6 genes associated with a panic disorder
COMT CCK CCKb receptor Adenosine A2 receptor Monoamine oxidase A 5-HT2 receptor
What are the 5 main types of anxiolytic drugs
Benzodiazepines 5-HT1a agonists SSRI SNRI beta-adrenoceptor antagonist
Name 3 benzodiazepines used to treat anxiety
Clonazepam
Alprazolam
Lorazepam
Name 2 5-HT1a agonists used to treat anxiety
buspirone
ipsapirone
Name 3 SSRI used to treat anxiety
Fluxetine
Escitalopram
Paroxetine
Name 2 SNRI used to treat anxiety
Venlafaxine
Duloxetine
Name a beta drenoceptor antagnoist used to treat anxiety
Propanol
Why are barbiturates no longer used
Major risk of dependencetion
Development of tolerance
Induction of liver microsomal enzymes
Fatal toxicity in overdose
What binding site is present on GABA receptor
Benzodiazepine
Effect of benzodiazepine binding to GABA receptor
Positive allosteric modulator
Enhances inhibitory effect of GABA
Increased frequency of channel opening or increased duration channels are open
What drug is used to treat benzodiazepine overdose
Flumazenil
How does flumazenil work
Antagonist at benzodiazepine binding sites
Where do zaleplon and zolpidem bind
alpha 1 subunit of GABA
