Sleep Drugs - Egleton Flashcards
hypnotics
sleep induced drug
how long can a patient be put on hynotics
should not be sued for more than one month
transient insomnia
few days
short-term insomnia
several weeks
long term insomnia
greater than 3 weeks
name the 5 drugs of BDZ for sleep disorder
Flurazepam Temazepam Triazolam Quazepam Estazolam
what do BDZ do to sleep architecture
alters it
what is the net effect on sleep time for BDZ
increases
what will develop with long term use of BDZ
tolerance
Flurazepam reduces what
sleep induction time
number of awakening
what is the draw back of Flurazepam
long half life, daytime sedation
Temazepam is useful in patients who experience what
frequent wakening
when should Temazepam be given
1-2 hours before desired bedtime
Triazolam is used in what type of patients
recurring insomnia
-patients who have difficulty going to sleep
what is the recommended dosing for Triazolam
intermittently rather then daily b/c tolerance develops over a few days. withdrawal results in rebound insomnia
Zolpidem works on what receptors
BDZ
non-BDZ drug
why is Zolpidem perscribed more
perceives sleep structure
what receptor does Zaleplon attach to
BDZ
non-BDZ drug
what is Zaleplon used for
good for broken sleep
what happens after 1 night of withdrawel of zaleplon
rebound insomnia but soon resolves
compare the half life of Eszopicione and Zolpidem and Zaleplon
longer than Zolpidem and zalelpon
What do Barbiturates do at low concentrations and high concentrations
low: depress CNS activity
high: depress activity of nerve, skeletal muscle, and smooth and cardiac muscle
Mechanism of action of Barbiturates
open channel for longer periods compared to BDZ
Potentiate GABA action
increasing Cl‐ conductance
which Barbiturates induces anesthesia
Thiopental
what are BARBS effect on sleep
decrease time spent in 3 and 4 stages
decrease number of REM cycles
what are respiration and cardiovascular effects of BARBS
depress neurogenic drive of respiration
minimal cardiovascular effects at hypnotic doses
how does BRABS work at high doses
mimic GABA
depress Ca2+ currents and Ca2+ dependent release of
neurotransmitter
what are hepatic side effects of BARBS
induction of hepatic enzymes
absolutely contraindicated for acute or intermittent porphyria
you should not perscribe BRABS to what type of patients and why
crosses placenta and appears in breast milk
BARBs produce no analgesia and may produce what in response to painful stimulation
hyperalgesia
BARB can be used as what type of serum? name the drugs
truth serum
Amobarbital
Pentobarbital
thiopental
is there an antidote for BARB
no
what happens with chronic use of BARb
down regulates GABA receptors, increase cholinergic activity and elevates glutamate receptors
-potentially life threatening
what is the mechanism of withdrawel for BARb
intense cholinergic activity
little GABA effect
EXCITMENT
chloral hydrate + alcohol =
” knock out drop”
enhances effects of CNS depressants
Diphenhydramine is also known as
Benadryl
Diphenhydramine is an antagonist for what
histamine H1
where is Melatonin synthezied
pineal gland from tryptophan
MOA for ramelton
melatonin receptor agonist
what is good about ramelton
minmal rebound insomnia
no abuse potential
when is ramelton used
Sleep disorders when onset is delayed
when is alcohol used as a treatment
Used in methanol or ethylene glycol intoxication due to greater affinity of alcohol
dehydrogenase for ethanol, resulting in a decrease in formation of toxic metabolites
what is used to treat alcoholism
Disulfiram
- inhibits aldehyde dehydrogenase
MOA of Naltrexone
opioid receptor antagonist
Acamprosate is a structural analog for what
GABA
what is the use for Modafinil
narcolepsy
shift work
obstructive sleep apnea
what is the use for Gamma hydroxybutyrate
Cataplexy
disrupted night time sleep
