anxiolytics and hypnotics Flashcards
1st line tx seizure in community
buccal midazolam
rectal diazepam
what is the mester regulatory nucleus of sleep cycle
the suprachiasmatic nucleus (SCN) in the hypothalamus
Neurons in the SupraChiasmaticNucleus …their activity during the light phase and … it during the dark phase
increase
decrease
describe the neuronal projections involved in sleep and wakefulness
Wakefulness: cholinergic systems (pedunculopontine
and laterodorsal tegmental nuclei)
monoaminergic projections (locus coeruleus, raphe nuclei,
tuberomamillary nucleus)
Sleep: GABA and galanin neurons (ventrolateral preoptic nucleus)
orexin is a …
peptide
orexin regulates (3)
arousal, appetite, wakefulness
deficiency in orexin leads to
narcolepsy
one sleep cycle lasts how long
90mins
how many NREM stages are there and what is characterisitc of the waves
4
as sleep gets deeper, waves gain amplitude but frequency decreases
which NREM stage involves sleep spindles
2
one particular gene which is upregulated in addiction - increases neuroplasticity
deltafosB
longterm insomnia definition
occurs> 3 nights a week and > 3 months
sleep disorders may be a prodromal sign of…
neurodegeneration
which benzo for insomnia, short term
something with a short half life eg tamazepam. NOT diazepam
new better drugs for insomnia, not yet licensed in UK
orexin antagonists - suvorexant, daridorexant
the GABAa receptor controls what ion passage
Cl-
which axis in most linked to stress response
Hypothalamus - pituitary - adrenal
what receptor do benzos work on and what do they do
GABAa, increase activitt allosterically (as in, don’t bind to same bindin site as GABA)
what do you use for benzo overdose and what is the problem
Flumazenil - BENZO overdose antagonist. NB has short half-life so you have to keep giving it
complications of benzo use in the elderly (5)
Psychomotor impairment
Risk of falls
Daytime drowsiness
Intoxication
Amnesia
Depression
Respiratory problems
Abuse and dependence
Which subunits of GABA receptors are involved in what? Which drugs target them
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
what is the effect of benzos vs barbiturates on the GABAa channel
benzos in crease freq of opning whereas barbs increase duration of opening
