Drugs to treat Insomnia

Question 1

Barbiturates work how?

Answer 1

Modulate GABA receptors in the CNS.

They make GABA action last longer. At very high doses may activate GABA itself.

Question 2

AE’s of barbiturates?

Answer 2

increase as the dosing gets higher, duh..,,Sedation, hypnosis, anesthesia, all the way to coma….This is why they are rarely used these days

Question 3

Benzodiazepines do what

Answer 3

MODULATE GABA receptors….that is, they shift the dose response curve to the left meaning less GABA creates a greater action.

Question 4

adverse effects of benzos

Answer 4

sedation, cognitive impairment, rebound insomnia with short acting drugs

Question 5

Withdrawal symptoms of benzos

Answer 5

anxiety, irritability, restlessness, sleep apnea, respiratory depression

Question 6

Benzos bind what subunit of the GABA receptor

Answer 6

alpha

Question 7

different subgroups of binding sites for Benzos on the alpha subunit of GABA receptor

Answer 7

BZ1- sedation/amnesia

BZ2- anxiolysis

BZ3- myorelaxation/anticonvulsant

Question 8

All benzos are ultimately eliminated how?

Answer 8

conjugated and then renally excreted

Question 9

Know the benzo drugs

Answer 9

ok

Question 10

Benzodiazepine receptor agonists can be used during pregnancy,,, they are cat c

Answer 10

ok

Question 11

Flumazenil

Answer 11

Benzo antagonist. Reversal of sedation from benzo/benzo agonists. IV quick acting. causes abrupt awakening. Can cause seizure and withdrawl in chronic benzo users. Does not reverse sedation.

Question 12

What does melatonin do

Answer 12

affects teh suprachiasmatic nucleus activity

Question 13

Of the three melatonin receptors, which affect the sleep/wake cycle

Answer 13

MT-1 and 2