ANXIOLYTICS AND HYPNOTICSPharmacology of anxiety and sleep disorders Flashcards
Which nuclei controls the 24hr rhythm / circadian rhythm of the body?
suprachiasmatic nucleus
Which neuronal projections control wakefulness? [2]
Which neuronal projections control sleep? [2]
Wakefulness:
* cholinergic systems
* monoaminergic projections
Sleep:
* GABA
* Galanin neurons
GABA & Galanin neurons project from which nucleus?
Paraventricular nucleus
Suprachiasmatic nucleus
Arcuate nucleus
Pre-optic nucleus
Supraoptic nucleus
GABA & Galanin neurons project from which nucleus?
Paraventricular nucleus
Suprachiasmatic nucleus
Arcuate nucleus
Ventrolateral Pre-optic nucleus
Supraoptic nucleus
Label A
REM sleep
Which EEG wave represents feeling of being drowsy?
Alpha
Beta
Theta
Delta
Which EEG wave represents feeling of being drowsy?
Alpha
Beta
Theta
Delta
Which sleep stage does this EEG show?
Beta
REM
Theta
Alpha
Delta
Delta
Which sleep stage does this EEG show?
Beta
REM
Theta
Alpha
Delta
Which sleep stage does this EEG show?
Beta
REM
Theta
Alpha
Delta
Which sleep stage does this EEG show?
Beta
REM
Theta
Alpha
Delta
Which sleep stage does this EEG show?
Beta
REM
Theta
Alpha
Delta
Which sleep stage does this EEG show?
Beta
REM
Theta
Alpha
Delta
Which sleep stage does this EEG show?
Beta
REM
Theta
Alpha
Delta
Describe sleep cycles [2]
Every sleep cycle lasts approximately 90 minutes
The cycles are not identical in the ratio NREM/REM sleep
What is the role of sleep? [6]
Maintenance of important cellular processes (e.g. biosynthesis of macromolecules and nuclear maintenance)
Waste clearance (e.g. elimination of brain metabolic products)
Neurodevelopment – consolidation of brain circuits
Regulation of the immune system and inflammation
Consolidation of memory processes
Sleep disorders may be a prodromal sign of []
Sleep disorders may be a prodromal sign of neurodegeneration
What are the three types of insomnia? [3]
Transient (e.g. jet lag…)
Short-term (e.g. associated with illness, bereavement, stress…)
Chronic (lasts longer than 3 weeks – analyse the underlying cause!)
What is the biggest cause of insomnia?
Primary insomnia
Psyciatric disorders
Medication
Unknown
What is the biggest cause of insomnia?
Primary insomnia
Psyciatric disorders
Medication
Unknown
Which stage of sleep normally lasts the longest?
Stage 1
Stage 2
Stage 3
Stage 4
REM
Which stage of sleep normally lasts the longest?
Stage 1
Stage 2
Stage 3
Stage 4
REM
Which drug classes are current treatments for insomnia? [2]
Benzodiazepine - short acting
Z drugs
Name drugs & the drug class they belong to, to treat short term [2]& long term insomina [2]
Short-term use:
* lorazepam (benzo)
* temazepam (benzo)
Long-term use:
* eszopiclone (benzo)
* Zolpidem (Z-drug)
What is the difference in half lifes between Z-drugs and benzodiazepines? [2]
Z-drug: short half life
Benzos: long half life
Name a drug that used for epilepsy that has recent use for insomnia [1]
Pregabalin
What are 5 side effects of using benzodiazepines used as hypnotics? [5]
- Change in sleep patterns (suppress deep sleep and REM sleep - which is the period you become most rested in)
- Daytime sedation
- Rebound insomnia
- Tolerance
- Dependence
Explain should you use to treat for chronic insomnia [2]
Cognitive Behavioural Therapy: otherwise become dependent on hypnotics
Define narcolepsy [1]
a condition characterised by excessive sleepiness; increased frequency of falling asleep in daytime
A deficiency in which pepitde causes narcolepsy? [1]
Orexins
Name an orexin antagonist that can treat insomnia [1]
Orexins bind to which receptors to promote wakefullness? [2]
Suvorexant: dual orexin receptor antagonist
Orexins bind to OX1 & OX2 receptors
(not in drug list)
A 51-year-old man is brought to the healthcare provider by his wife. She states that he has had significant trouble waking up in the mornings. The patient says he has to be shaken awake, after which he is drowsy, has reduced work performance, and keeps wanting to go back to sleep. He says, “It’s like my mind is all fogged up.” These symptoms last 30 minutes to an hour. The patient has most likely been woken up from which of the following stages of sleep?
A. Stage 1
B. Stage 2
C. Stage 3
D. REM sleep
A 51-year-old man is brought to the healthcare provider by his wife. She states that he has had significant trouble waking up in the mornings. The patient says he has to be shaken awake, after which he is drowsy, has reduced work performance, and keeps wanting to go back to sleep. He says, “It’s like my mind is all fogged up.” These symptoms last 30 minutes to an hour. The patient has most likely been woken up from which of the following stages of sleep?
A. Stage 1
B. Stage 2
C. Stage 3
D. REM sleep
A 22-year-old male presents to the clinic with the inability to stay awake. He falls asleep at inconvenient times and has even fallen asleep driving. An electroencephalogram (EEG) is ordered and shows a sudden transition into a stage of sleep, which resembles an awake individual, but muscle tone is lost. The patient has no other underlying conditions, and the physical examination is normal. Which of the following is another characteristic of this stage of sleep?
A. K complexes
B. Sleep spindles
C. Theta waves
D. Dreaming
A 22-year-old male presents to the clinic with the inability to stay awake. He falls asleep at inconvenient times and has even fallen asleep driving. An electroencephalogram (EEG) is ordered and shows a sudden transition into a stage of sleep, which resembles an awake individual, but muscle tone is lost. The patient has no other underlying conditions, and the physical examination is normal. Which of the following is another characteristic of this stage of sleep?
A. K complexes
B. Sleep spindles
C. Theta waves
D. Dreaming
