Chapter 14-3

Question 1

Antihypnotic drugs ____ sleep

Answer 1

Reduce

Question 2

Examples of antihypnotic drugs:

Answer 2

• Stimulants (cocaine, amphetamines)
• Tricyclic antidepressants (increase norepinephrine, epinephrine, dopamine)

Question 3

Hypnotic drugs ____ sleep:

Answer 3

Induce

Question 4

Examples of hypnotic drugs:

Answer 4

• Benzos
• Barbiturates
• Imidazopyridines
• 5-HTP

Question 5

Influence of melatonin on sleep:

Answer 5

Influences circadian rhythmicity

Question 6

Effects of LT use of benzodiazepines:

Answer 6

• Tolerance
• Addiction
• Withdrawal

Question 7

Main effect of benzodiazepines:

Answer 7

Anxiolytics (reduce anxiety)

Question 8

How do benzodiazepines distort sleep?

Answer 8

• Distort’s sleep pattern
• Increases NREM2 and decreases Short Wave and REM

Question 9

What drug classification is Valium (diazepam)?

Answer 9

Benzodiazepine

Question 10

What drug classification is Ambien (zolpidem)?

Answer 10

Imidazopyridine

Question 11

Pharmacokinetics of Imidazopyridines:

Answer 11

Acts on Benzodiazepine binding site
- Faster acting than BDZs
- Shorter half-life

Question 12

How does prescription of imidazopyridines differ between men & women:

Answer 12

Women are recommended to take reduced dosages per the FDA

Question 13

Where does 5-HTP target?

Answer 13

Raphe nuclei of SCN -> serotonin output

Question 14

5-HTP is a precursor of ____

Answer 14

Serotonin

Question 15

5-HTP effects in humans:

Answer 15

Very limited (if any)

Question 16

5-HTP effects in cats and rats:

Answer 16

Reverses insomnia induced in cats & rats by 5-HT agonist PCPA

Question 17

Why is melatonin considered a chronobiotic?

Answer 17

Significant effects in shifting sleep cycle, rather than promoting sleep

Question 18

Iatrogenic causes of insomnia:

Answer 18

Over-prescription of BDZ, imidazopyridines, etc

Question 19

Sleep apnea types:

Answer 19

Obstructive or central

Question 20

What is nocturnal myclonus?

Answer 20

Periodic limb movement disorder
- Multiple awakenings due to twitching of the body (usually legs)

Question 21

What is restless legs?

Answer 21

Trouble falling asleep because of tension in legs

Question 22

What is hypersomnia?

Answer 22

Narcolepsy
Insufficient sleep (Sleep apnea, restless leg, etc)

Question 23

Reasons for hypersomnia:

Answer 23

• Sleep apnea
• Restless leg
• Psychiatric (ie. depression)
• Circadian rhythm disruptions/disorders (shift work, jet lag)
• Substance-induced sleep disorders
• Due to medical condition (Parkinson’s, MS, chronic fatigue syndrome)

Question 24

5 core symptoms of narcolepsy:

Answer 24

1. Excessive daytime sleepiness and/or sleep attacks
2. Cataplexy (loss of muscle tone when sleeping)
3. Sleep paralysis (inability to move when falling asleep, related to loss of muscle tone)
4. Hypangogic hallucinations (dream-like experiences during wakefulness)
5. Fragmented sleep

Question 25

What part of the brain is active during cataplexy?

Answer 25

Nucleus magnocellularis

Question 26

What happens to orexin KO mice:

Answer 26

Narcoleptic

Question 27

Genetic predisposition to narcolepsy:

Answer 27

25% in identical twins

Question 28

Other causes of narcolepsy:

Answer 28

- Infection (H1N1) - Brain injury/tumour

Question 29

Nucleus magnocellularis is active during ____

Answer 29

Cataplexy

Question 30

Orexin neurons in the posterior hypothalamus project to regions in the reticular formation that:

Answer 30

1. Promote wakefulness 2. Inhibit muscle paralysis

Question 31

Narcolepsy treatments:

Answer 31

1. Stimulants 2. Novel stimulants 3. Antidepressants can ease cataplexic symptoms 4. Sodium oxybate- GABAb agonist

Question 32

What is an REM sleep disorder?

Answer 32

Lack of REM sleep atonia (loss of muscle tone)

Question 33

What stage of sleep is the most prevalent in narcoleptics?

Answer 33

REM sleep in initial stage 1