Unit 4: Sleep and Insomnia Flashcards
L1: Which “Z” drug is best used as a sleep aid in the middle of the night, since it does not reduce nocturnal awakenings?
Zaleplon
L1: Which “Z” drug is the most widely prescribed hypnotic agent?
Zolpidem
L1: Which stage of sleep? Decreased muscle tone, increased BP/HR/RR
REM
L1: Which stage of sleep? Delta wave (very slow) EEG), deepest level of sleep
3 and 4
L1: Which stage of sleep? EEG looks awake but arousal threshold is elevated
REM
L1: Which stage of sleep? Light sleep, slower EEG
2
L1: Which stage of sleep? May be involved in synaptic pruning and tuning
3 and 4
L1: Which stage of sleep? Transition phase, EEG appears like wakefulness
1
L1: Which stage of sleep? When dreams and somnambulism occur
3 and 4
L2: ________: sleepiness waxes and wanes as according to signals in the suprachiasmatic nuclei
Circadian altering system
L2: ________: the longer we are awake, the sleepier we get; mediated by adenosine
Homeostatic Drive
L2: Name the status on/off of the following neurotransmitter during wakefulness and NREM sleep. Orexin
Active, off
L2: Name the status on/off of the following neurotransmitter during wakefulness and REM sleep. DA
Active, off
L2: Name the status on/off of the following neurotransmitter during wakefulness, NREM sleep, and REM sleep. 5HT
Active, reduced, off
L2: Name the status on/off of the following neurotransmitter during wakefulness, NREM sleep, and REM sleep. ACh
Active, off, active/very active
L2: Name the status on/off of the following neurotransmitter during wakefulness, NREM sleep, and REM sleep. GABA
Off, active, reduced
L2: Name the status on/off of the following neurotransmitter during wakefulness, NREM sleep, and REM sleep. Histamine
Active, reduced, off
L2: Name the status on/off of the following neurotransmitter during wakefulness, NREM sleep, and REM sleep. NE
Active, reduced, off
L2: Place the “Z” drugs in order of increasing half-life.
Zaleplon, Zolpidem, Esziopiclone
L2: Place the following Benzodiazepines in order of increasing half-life: flurazepam, temazepam, triazolam
Triazolam, Temazepam, Flurazepam
L2: Which agent for insomnia has agonist, antagonist, and reuptake inhibition actions on 5HT neurons?
Trazodone
L2: Which agent for insomnia is an agonist at MT1 and MT2 melatonin receptors in the suprachiasmatic nucleus of the hypothalamus?
Ramelteon
L2: Which agent for insomnia is an antagonist at H1 histamine receptors and muscarinic receptors?
Diphenhydramine
L2: Which agent is a 5HT +/- NE reuptake inhibitor, histamine antagonist, and cholinergic antagonist?
Amitriptyline
L2: Which agent is an antidepressant used for insomnia, especially in patients prone to substance abuse?
Trazodone
L2: Which BDZ used in treatment of insomnia can lead to rebound insomnia upon withdrawal?
Triazolam
L2: Which BDZ used in treatment of insomnia has the highest risk of daytime sedation, especially among elderly patients?
Flurazepam
L2: Which BDZ used in treatment of insomnia has the least depression of REM sleep?
Flurazepam
L2: Which brain structure? Ascending cortical activation, switch between SWS and REM
Brainstem
L2: Which brain structure? Circadian clock that modulates alterness, core body temperature, and melatonin secretion
Suprachiasmatic Nucleus
L2: Which brain structure? Location where adenosine accumulates during wakefulness and decreases during sleep
Basal forebrain
L2: Which brain structure? Responsible for generating slow wave sleep
Thalamus
L2: Which brain structure? Sleep/wake switch
Hypothalamus
