Sleep Treat Flashcards
What is the role of sleep in the body?
Sleep allows for body restoration and recovery and promotes memory consolidation
What are the two types of sleep?
- Non-rapid eye movement (NREM) sleep
- Rapid eye movement (REM) sleep
What neurotransmitters decrease during the initiation of NREM sleep?
- Norepinephrine (NE)
- Serotonin (5HT)
- Histamine
- Acetylcholine (Ach)
What happens during REM sleep?
Increased brain activity, dreams, hallucinations, memory consolidation, and body paralysis (decreased muscle tone)
What happens when sedative-hypnotic drugs are discontinued?
Increased REM rebound (nightmares) and decreased NREM sleep (insomnia)
What are common causes of insomnia?
- Medical or mental illnesses (e.g., depression, bipolar disorders)
- Pain (e.g., arthritis, dyspepsia)
- Dyspnea
- Frequency of micturition
- Drugs (e.g., caffeine, nicotine, alcohol withdrawal)
Name some benzodiazepines used as sedatives.
- Triazolam
- Lorazepam
- Oxazepam
- Alprazolam
- Diazepam
- Clonazepam
What are some barbiturates mentioned in the text?
- Thiopental
- Pentobarbital
- Phenobarbital
What are GABA A receptors?
Ligand-gated channels permeable to Cl- that mediate inhibition and decrease excitability
What is the mechanism of action of benzodiazepines?
Benzodiazepines bind to an allosteric modulatory site on GABA A receptors to increase the affinity of GABA for its receptor
What is the difference in action between benzodiazepines and barbiturates?
Benzodiazepines increase the frequency of Cl- channel opening, while barbiturates increase the duration of Cl- channel opening
What are the effects of benzodiazepines and barbiturates?
- Sedation
- Hypnosis
- Anesthesia
- Anticonvulsants
- Muscle relaxants
What are the risks associated with sedative-hypnotic drugs?
CNS adverse effects, such as drowsiness, impaired judgment, diminished motor skills, and anterograde amnesia
True or False: Most sedative-hypnotic drugs are classified as schedule III or IV controlled drugs.
True
What are some common non-CNS adverse effects of sedative-hypnotics?
Hypersensitivity reactions and teratogenicity
What is the therapeutic plan for managing insomnia?
- Non-pharmacologic therapies (proper diet, exercise, avoiding stimulants, comfortable environment)
- Pharmacologic therapies (selection of drugs with rapid onset and minimal hangover)
What is the indication for Zolpidem?
Short-term treatment of insomnia
What are the side effects of Eszopiclone?
Less amnesia or day-after somnolence than zolpidem or benzodiazepines
What is the mechanism of action of ramelteon?
Selective agonist at MT1 and MT2 melatonin receptors
What are the indications for Suvorexant?
Insomnia
What type of receptors do sedative antidepressants primarily block?
H1 receptors
Fill in the blank: Most benzodiazepines are classified as category _____ or _____.
D or X
