anxiolytics and hypnotics

Question 1

1st line tx seizure in community

Answer 1

buccal midazolam
rectal diazepam

Question 2

what is the mester regulatory nucleus of sleep cycle

Answer 2

the suprachiasmatic nucleus (SCN) in the hypothalamus

Question 3

Neurons in the SupraChiasmaticNucleus …their activity during the light phase and … it during the dark phase

Answer 3

increase
decrease

Question 4

describe the neuronal projections involved in sleep and wakefulness

Answer 4

Wakefulness: cholinergic systems (pedunculopontine
and laterodorsal tegmental nuclei)
monoaminergic projections (locus coeruleus, raphe nuclei,
tuberomamillary nucleus)

Sleep: GABA and galanin neurons (ventrolateral preoptic nucleus)

Question 5

orexin is a …

Answer 5

peptide

Question 6

orexin regulates (3)

Answer 6

arousal, appetite, wakefulness

Question 7

deficiency in orexin leads to

Answer 7

narcolepsy

Question 8

one sleep cycle lasts how long

Answer 8

90mins

Question 9

how many NREM stages are there and what is characterisitc of the waves

Answer 9

4
as sleep gets deeper, waves gain amplitude but frequency decreases

Question 10

which NREM stage involves sleep spindles

Answer 10

2

Question 11

one particular gene which is upregulated in addiction - increases neuroplasticity

Answer 11

deltafosB

Question 12

longterm insomnia definition

Answer 12

occurs> 3 nights a week and > 3 months

Question 13

sleep disorders may be a prodromal sign of…

Answer 13

neurodegeneration

Question 14

which benzo for insomnia, short term

Answer 14

something with a short half life eg tamazepam. NOT diazepam

Question 15

new better drugs for insomnia, not yet licensed in UK

Answer 15

orexin antagonists - suvorexant, daridorexant

Question 16

the GABAa receptor controls what ion passage

Answer 16

Cl-

Question 17

which axis in most linked to stress response

Answer 17

Hypothalamus - pituitary - adrenal

Question 18

what receptor do benzos work on and what do they do

Answer 18

GABAa, increase activitt allosterically (as in, don’t bind to same bindin site as GABA)

Question 19

what do you use for benzo overdose and what is the problem

Answer 19

Flumazenil - BENZO overdose antagonist. NB has short half-life so you have to keep giving it

Question 20

complications of benzo use in the elderly (5)

Answer 20

Psychomotor impairment
Risk of falls
Daytime drowsiness
Intoxication
Amnesia
Depression
Respiratory problems
Abuse and dependence

Question 21

Which subunits of GABA receptors are involved in what? Which drugs target them

Answer 21

α subunits are the target of Z-drugs
zaleplon and zolpidem bind to the α1 subunit – hypnotic role

α2 subunits are linked to anxiolytic effects

Question 22

what is the effect of benzos vs barbiturates on the GABAa channel

Answer 22

benzos in crease freq of opning whereas barbs increase duration of opening