Anxiolytics And Hypnotics Flashcards

1
Q

uses of anxiolytics and hypnotics

A

Relieve anxiety
Induce sleep
Sedation and amnesia before medical procedures
Control of withdrawal
Muscle relaxation
Severe behavioural disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which nucleus controls the circadian rhythm

A

Suprachiasmatic nucleus in hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How are suprachiasmic neurone nuclei effected by light cues

A

Incr activity in light
Decr activity in dark

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What NT systems are involved in wakefulness

A

Cholinergic
Monoaminergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What NT systems are involved in sleep

A

GABA
galanin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which sleep promoting NT does caffeine antagonise

A

Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How long does a sleep cycle last

A

90 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 phases of the sleep cycle

A

REM - rapid eye movement
NREM - non rapid eye movement
SWS - slow wave sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Characteristics of REM sleep

A

Rapid eye movement
Low muscle tone
Dreams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can disturb the sleep cycle

A

Night shifts
Jetlag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are sleep stages assessed

A

Polysomnigraphy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When are alpha waves seen on EEG

A

Awake and relaxed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When are beta waves seen on EEG

A

Normal wakefulness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Role of sleep

A

Cellular processes and biosynthesis
Waste clearance
Neuro development
Immune system and inflammation regulation
Memory consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Insomnia types

A

Transient
Short term
Chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can sleep disorders precede

A

Neurodegeneration
Parkinson’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Insomnia management

A

Referral to sleep specialist
Advice on sleep habits and lifestyle
Benzodiazepines
Z drugs
Pregabalin
CBT
Sedating antidepressants
Orexin antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Z drugs

A

Zaleplon
Zolpidem
Zopiclone
Eszopiclone

19
Q

Why are not all benzodiazepines suitable for insomnia

A

Long lasting benzodiazepines make it difficult to get up in the morning and leave hangover like effects

20
Q

Short term insomnia drug treatment

A

Lorazepam
Temazepam

21
Q

Long term insomnia drug treatment

A

Eszopiclone
Zolpidem

22
Q

Benzodiazepine adverse effects and disadvantages in insomnia treatment

A

Changes to sleep patterns
Daytime sedation
Rebound insomnia
Tolerance
Dependence and withdrawal

23
Q

Why should hypnotics not be prescribed long term

A

Dependence

24
Q

Narcolepsy

A

Condition characterised by excessive daytime sleepiness and increased freq of falling asleep during daytime

25
Q

Do orexins cause sleep or wakefulness and what is the result of their deficiency

A

Regulate wakefulness
Deficiency causes narcolepsy

26
Q

What receptors mediate effects of orexins

A

OX 1
OX 2

27
Q

Suvorexant MOA

A

Dual orexin receptor antagonist

28
Q

NTs involved in anxiety disorders

A

Noradrenaline
5HT
GABA

29
Q

What structures are commonly uncontrollably hyperactive in anxiety

A

Limbic structures

30
Q

What axis is the stress axis

A

Hypothalamus-pituitary-adrenal axis

31
Q

Does KF-1 ubiquitin ligase suppress or induce anxiety

A

Supress

32
Q

What treatments increase KF1

A

Chronic SSRIs
Electroconvulsive therapy

33
Q

Anxiolytic types

A

SSRIs
SNRIs
Benzodiazepines
5HT1a agonists
Beta adrenoreceptor antagonist’s

34
Q

What drug type are venlafaxine and duloxetine

A

SNRIs

35
Q

What drug type is propranolol

A

Beta adrenoreceptor antagonist

36
Q

What drug type are buspirone and ipsapirone

A

5HT1a partial agonists

37
Q

What drug type are clonazepam alprazolam and lorazepam

A

Benzodiazepines

38
Q

What drug type are fluoxetine, escitalopram, and paroxetine

A

SSRI

39
Q

Why are barbiturates no longer used for anxiety

A

Affect other drugs by increasing liver enzyme activity
Dependence
Can use to commit suicide
Withdrawal

40
Q

benzodiazepines MOA

A

GABAa positive allosteric modulator

41
Q

What is the difference between effects of benzodiazepines and barbituates on GABAa channels

A

Benzodiazepines incr opening frequency
Barbituates incr opening duration

42
Q

Which drug is used to reverse benzodiazepines overdose

A

Flumazenil

43
Q

Benzodiazepines risks opinion elderly

A

Psychomotor impairment
Fall risk
Daytime drowsiness
Intoxication
Insomnia
Amnesia
Depression
Respiratory problems
Abuse
Dependence

44
Q

Which GABAa receptor subunits targeted by z drugs are linked to hypnotic and anxiolytic effects

A

Alpha1 - hypnotic
Alpha2 - anxiolytic