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DT II Exam 1 > Egleton: Sleep disorders > Flashcards

Egleton: Sleep disorders Flashcards

1
Q

BDZ

A

Decrease sleep latency

Decrease number of awakenings

Increase awakening threashold

More Stage 2, Less Stage 3/4

Increase net sleep time

ADR: Tolerance

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2
Q

Flurazepam

A

BDZ Little rebound effect Long half life (85hr) ADR: Sleepy during the day

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3
Q

Temazapam

A

BDZ Peak sedative 1-3 hr after oral dose Should be given 1-2 hours before bedtime

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4
Q

Triazolam

A

BDZ Induce sleep who are difficult falling asleep Short duration action Use intermittently Tolerance development

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5
Q

Zolouden

A

Work at BDZ receptors Quick onset Miminal rebound insomnia Less side effects Preserves sleep structure

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6
Q

Zaleplon

A

Work at BDZ receptor Rapid onset For broken sleep Rebound insomnia the first night, soon resolves Abuse potential

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7
Q

Eszopicione

A

BDZ like drug Longer half life than Zolpidem, Zaleplon Not restricted for short term use

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8
Q

Barbituates

A

Sedative hypnotics

ADR: tolerance, Coma at toxic dose, No antidotes

Decrease stage 3 and 4

Decrease # REM cycle and time in REM

Tolerance decelops to these effects

Depress neurogenic drive of respirataion

Minimal CVeffects at hypnotic doses

Activates delta-aminolevulinic acid synthetase

Contraindicated for porphyria

Don’t give to pregnant and breastfeeding mother

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9
Q

Barbituates: MoA

A

BDZ like

Open channels longer

Inhibit release of excitatory transmitters

At high dose, mimic GABA

Depress Ca currents and Ca dep neurotransmitter release

Stabilize membrane

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10
Q

BARBs: therapeutic use

A

Antagonize CNS stimulants

Anticonvulsants

Induce anesthesia: Thiopental

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11
Q

BARBs: tolerance

A

Tolerance to hyptonic effects of BARBS dose occur

Cross tolerance to other CNS depressants

Withdrawal reaction

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12
Q

BARB: analgesia

A

Hyperalgesia= more pain

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13
Q

Amobarbital, Pentobarbital, Thiopental

A

Trueth serum

IV admin

Sedation produce

Remove inhibition

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14
Q

BARB acute toxicity

A

Stupor/ coma

Respiratory depression

Circulatory collapse

Treatement:

Removeal of unabsorbed drug by lavage

Artifical ventilation

Hemodialysis

Charcoal

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15
Q

Abstitence syndrome

A

Chronic use downregulates GABA receptor

Increase cholinergic activity and elevates glutamate receptors

Potentially life threatening

Upon withdrawal intense cholinergic activity

Net effect= excitement

Treat

Hospitalization and stabilization with lowest dose that prevents syndrome

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16
Q

Chloral hydrate

A

Oral hypnotic

Rapid acting

GI irritation

Prodrug: active metabolite is trichloroethanol

Wide margin of safety

Enhances CND depressants effects

Used in treatment of mild insomnia

Less effective than BDZ

17
Q

Diphenhydramine, Doxylamine

A

Histamine H1 antagonists

Used in treatment of mild insomnia

Less effective than BDZ

18
Q

Melatonin

A

Made in Pineal gland from Tryptophan

Secreated to diurnal rhythm

Increase in late evening (peak at midnight) Decreae in morning

May decrease insomnia

19
Q

Ramelton

A

Melatonin receptor agonist MT1 and2

For delayd onset sleep

No abuse potential

Minimal rebound insomnia

ADR: dizziness, sleepiness

Interaction: with other depressants

20
Q

Alcohol

A

CNS depressant

GABA receptor allosteric modulator

Decrase Na/ Ca influx

Additive effect to CNS depressants

Relax> Ataxia> Coma> Death

21
Q

Alcohol: other effects

A

Peripheral vasodilation

Increase salivary/ gastric secretion

Diuretics

Accumulation of lipid in liver

Increase HDL in plasma

Chronic excessive use= cardiomyopathy

22
Q

Ethanol: use

A

Methanol/ Ethlene glycol intoxication

Greater affinity to alcohol dehydrogenease

Reduction of fever

Prevent decubitus ulcers

Disinfectant

Remove toxicodendrol

23
Q

Disulfiram

A

Inhibit Alcohol dehydrogenase

Resut in accumulation of Acetaldehyde

Flushing, tachycardia, hyperventilation, nausea

24
Q

Naltrexone

A

Treat withdrawal/ relapse

Opioid receptor antagonist

Reduces craving/ blunts plesurable effects

Decrease DA release in Nucleus accumbens

ADR: Nausea

25
Q

Acamprosate

A

Treat withdrawal relapse

Structural analog of GABA

Decrease glutamate neurotransmission during alcohol withdrawl

Relapse prevention

ADR: Diarrhea

26
Q

Modafinil

A

Block dopamine transporter

For Narcolepsy, Shift work sleep disorder, Obstructive sleep apnea

Give at morning for narcolepsy

Give before shift for Shift work sleep disorder

ADR: careful with CV disease

27
Q

Gamma hydroxybutyrate

A

Natural product from GABA

GABA B receptor?

Reduces cataplexy

ADR: Dizziness, Nausea, Vomit, CV problem, Stevens-Johnson

DON’t take with alcohol

Metabolized via Krebs cycle

DT II Exam 1 (5 decks)

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