Anxiolytics And Hypnotics Flashcards
uses of anxiolytics and hypnotics
Relieve anxiety
Induce sleep
Sedation and amnesia before medical procedures
Control of withdrawal
Muscle relaxation
Severe behavioural disturbance
Which nucleus controls the circadian rhythm
Suprachiasmatic nucleus in hypothalamus
How are suprachiasmic neurone nuclei effected by light cues
Incr activity in light
Decr activity in dark
What NT systems are involved in wakefulness
Cholinergic
Monoaminergic
What NT systems are involved in sleep
GABA
galanin
Which sleep promoting NT does caffeine antagonise
Adenosine
How long does a sleep cycle last
90 mins
3 phases of the sleep cycle
REM - rapid eye movement
NREM - non rapid eye movement
SWS - slow wave sleep
Characteristics of REM sleep
Rapid eye movement
Low muscle tone
Dreams
What can disturb the sleep cycle
Night shifts
Jetlag
How are sleep stages assessed
Polysomnigraphy
When are alpha waves seen on EEG
Awake and relaxed
When are beta waves seen on EEG
Normal wakefulness
Role of sleep
Cellular processes and biosynthesis
Waste clearance
Neuro development
Immune system and inflammation regulation
Memory consolidation
Insomnia types
Transient
Short term
Chronic
What can sleep disorders precede
Neurodegeneration
Parkinson’s
Insomnia management
Referral to sleep specialist
Advice on sleep habits and lifestyle
Benzodiazepines
Z drugs
Pregabalin
CBT
Sedating antidepressants
Orexin antagonist
Z drugs
Zaleplon
Zolpidem
Zopiclone
Eszopiclone
Why are not all benzodiazepines suitable for insomnia
Long lasting benzodiazepines make it difficult to get up in the morning and leave hangover like effects
Short term insomnia drug treatment
Lorazepam
Temazepam
Long term insomnia drug treatment
Eszopiclone
Zolpidem
Benzodiazepine adverse effects and disadvantages in insomnia treatment
Changes to sleep patterns
Daytime sedation
Rebound insomnia
Tolerance
Dependence and withdrawal
Why should hypnotics not be prescribed long term
Dependence
Narcolepsy
Condition characterised by excessive daytime sleepiness and increased freq of falling asleep during daytime
Do orexins cause sleep or wakefulness and what is the result of their deficiency
Regulate wakefulness
Deficiency causes narcolepsy
What receptors mediate effects of orexins
OX 1
OX 2
Suvorexant MOA
Dual orexin receptor antagonist
NTs involved in anxiety disorders
Noradrenaline
5HT
GABA
What structures are commonly uncontrollably hyperactive in anxiety
Limbic structures
What axis is the stress axis
Hypothalamus-pituitary-adrenal axis
Does KF-1 ubiquitin ligase suppress or induce anxiety
Supress
What treatments increase KF1
Chronic SSRIs
Electroconvulsive therapy
Anxiolytic types
SSRIs
SNRIs
Benzodiazepines
5HT1a agonists
Beta adrenoreceptor antagonist’s
What drug type are venlafaxine and duloxetine
SNRIs
What drug type is propranolol
Beta adrenoreceptor antagonist
What drug type are buspirone and ipsapirone
5HT1a partial agonists
What drug type are clonazepam alprazolam and lorazepam
Benzodiazepines
What drug type are fluoxetine, escitalopram, and paroxetine
SSRI
Why are barbiturates no longer used for anxiety
Affect other drugs by increasing liver enzyme activity
Dependence
Can use to commit suicide
Withdrawal
benzodiazepines MOA
GABAa positive allosteric modulator
What is the difference between effects of benzodiazepines and barbituates on GABAa channels
Benzodiazepines incr opening frequency
Barbituates incr opening duration
Which drug is used to reverse benzodiazepines overdose
Flumazenil
Benzodiazepines risks opinion elderly
Psychomotor impairment
Fall risk
Daytime drowsiness
Intoxication
Insomnia
Amnesia
Depression
Respiratory problems
Abuse
Dependence
Which GABAa receptor subunits targeted by z drugs are linked to hypnotic and anxiolytic effects
Alpha1 - hypnotic
Alpha2 - anxiolytic
