Anxiolytics And Hypnotics

Question 1

uses of anxiolytics and hypnotics

Answer 1

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

Question 2

Which nucleus controls the circadian rhythm

Answer 2

Suprachiasmatic nucleus in hypothalamus

Question 3

How are suprachiasmic neurone nuclei effected by light cues

Answer 3

Incr activity in light
Decr activity in dark

Question 4

What NT systems are involved in wakefulness

Answer 4

Cholinergic
Monoaminergic

Question 5

What NT systems are involved in sleep

Answer 5

GABA
galanin

Question 6

Which sleep promoting NT does caffeine antagonise

Answer 6

Adenosine

Question 7

How long does a sleep cycle last

Answer 7

90 mins

Question 8

3 phases of the sleep cycle

Answer 8

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

Question 9

Characteristics of REM sleep

Answer 9

Rapid eye movement
Low muscle tone
Dreams

Question 10

What can disturb the sleep cycle

Answer 10

Night shifts
Jetlag

Question 11

How are sleep stages assessed

Answer 11

Polysomnigraphy

Question 12

When are alpha waves seen on EEG

Answer 12

Awake and relaxed

Question 13

When are beta waves seen on EEG

Answer 13

Normal wakefulness

Question 14

Role of sleep

Answer 14

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

Question 15

Insomnia types

Answer 15

Transient
Short term
Chronic

Question 16

What can sleep disorders precede

Answer 16

Neurodegeneration
Parkinson’s

Question 17

Insomnia management

Answer 17

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

Question 18

Z drugs

Answer 18

Zaleplon
Zolpidem
Zopiclone
Eszopiclone

Question 19

Why are not all benzodiazepines suitable for insomnia

Answer 19

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

Question 20

Short term insomnia drug treatment

Answer 20

Lorazepam
Temazepam

Question 21

Long term insomnia drug treatment

Answer 21

Eszopiclone
Zolpidem

Question 22

Benzodiazepine adverse effects and disadvantages in insomnia treatment

Answer 22

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

Question 23

Why should hypnotics not be prescribed long term

Answer 23

Dependence

Question 24

Narcolepsy

Answer 24

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

Question 25

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

Answer 25

Regulate wakefulness Deficiency causes narcolepsy

Question 26

What receptors mediate effects of orexins

Answer 26

OX 1 OX 2

Question 27

Suvorexant MOA

Answer 27

Dual orexin receptor antagonist

Question 28

NTs involved in anxiety disorders

Answer 28

Noradrenaline 5HT GABA

Question 29

What structures are commonly uncontrollably hyperactive in anxiety

Answer 29

Limbic structures

Question 30

What axis is the stress axis

Answer 30

Hypothalamus-pituitary-adrenal axis

Question 31

Does KF-1 ubiquitin ligase suppress or induce anxiety

Answer 31

Supress

Question 32

What treatments increase KF1

Answer 32

Chronic SSRIs Electroconvulsive therapy

Question 33

Anxiolytic types

Answer 33

SSRIs SNRIs Benzodiazepines 5HT1a agonists Beta adrenoreceptor antagonist’s

Question 34

What drug type are venlafaxine and duloxetine

Answer 34

SNRIs

Question 35

What drug type is propranolol

Answer 35

Beta adrenoreceptor antagonist

Question 36

What drug type are buspirone and ipsapirone

Answer 36

5HT1a partial agonists

Question 37

What drug type are clonazepam alprazolam and lorazepam

Answer 37

Benzodiazepines

Question 38

What drug type are fluoxetine, escitalopram, and paroxetine

Answer 38

SSRI

Question 39

Why are barbiturates no longer used for anxiety

Answer 39

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

Question 40

benzodiazepines MOA

Answer 40

GABAa positive allosteric modulator

Question 41

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

Answer 41

Benzodiazepines incr opening frequency Barbituates incr opening duration

Question 42

Which drug is used to reverse benzodiazepines overdose

Answer 42

Flumazenil

Question 43

Benzodiazepines risks opinion elderly

Answer 43

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

Question 44

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

Answer 44

Alpha1 - hypnotic Alpha2 - anxiolytic