Exam 4 - Yang Sleep Part 2 Flashcards
GABAb receptor is what type ________ and the significance of that is _______
Xyrem (sodium oxybate, GHB) MOA
binds to GABAa, GABAb, GHB receptors although full mechanism is unknown
Xyrem use
sleep agent used with stimulants to:
-decrease excessive daytime sleepiness
-increase daytime wakefulness
decrease cataplexy (sudden loss of muscle while awake, causes weakness and loss of muscle control)
Gamma-hydroxybutyric acid (GHB) use
CNS depressant used for sleep
GHB SE
-dizziness, drowsiness, coma
-sudden awakening at night
-NV, HA, Amnesia
-loss of consciousness, seizures, death
Ramelteon (Rozerem) MOA
melatonin agonist
-binds and activates MT1 and MT2 melatonin receptors
receptors are in SCN
ramelteon (Rozerem) use
for sleep in pts who have trouble with sleep onset
-non-controlled substance (no abuse or withdrawal)
tasimelteon (Hetlioz) MOA
melatonin agonist
-binds and activates MT1 and MT2 melatonin receptors
tasimelteon (Hetlioz) use
treatment of non-24-hr sleep wake disorder in blind pts
suvorexant (Belsomra) MOA
orexin receptor antagonist
-blocks OX1 and OX2 receptors
-receptors in hypothalamus
-reduce reward stimuli (DA release)
suvorexant (Belsomra) use
treats insomnia
-usually comes with morning impairment (use lowest possible dose)
drugs that may induce anxiety
cocaine
beta agonists (albuterol)
caffeine
corticosteroids
withdrawal associated with certain drugs (antidepressants, anxiolytics, drugs of abuse, social media)
excess _______ in the ______ can cause anxiety
norepinephrine, amygdala (fear center)
GABAergic system function
balances inhibitory/stimulatory effects of excess NE
drug options for anxiety
BZDs
antidepressants (SSRIs, SNRIs, TCAs)
buspirone
beta blockers
IN ketamine
