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PHRM2101 > WEEK 11: Mental Health > Flashcards

WEEK 11: Mental Health Flashcards

1
Q

T or F
‘poor mental health’ is the same as a ‘mental health disorder’.

A

F

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2
Q

“Mental” is a broad term and refers to the mind or the … system

A

central nervous

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3
Q

‘Mental health’ refers to what four main functions?

A

emotion, mood, thinking and behaviour

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4
Q

In order for a person’s mental health to be classified as being influenced by a disorder they must have changes in emotion, mood, thinking or behaviour that…

A
  • are persistent
  • are associated with distress and/or disablement
  • interfere with functioning in social, work or family activities/life
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5
Q

T or F
Not all anxiety disorders are regarded to be mental health disorders

A

T

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6
Q

T or F
Both psychologists and psychiatrists can provide psychotherapy.

A

T

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7
Q

What is somnolence?

A

Excessive sleeping. The opposite of insomnia.

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8
Q

T or F
tricyclic antidepressants (TCAs) often cause insomnia

A

F
They often cause sedation

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9
Q

T or F
selective serotonin reuptake inhibitors (SSRIs) tend to cause insomnia

A

T

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10
Q

T or F
Among the antipsychotic agents, there is much variability regarding the effects on sleep.

A

T

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11
Q

What does a hypnotic drug do?

A

Cause sedation.

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12
Q

Which brain regions are most commonly associated with mood?

A

The amygdala, hypothalamus and the hippocampus

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13
Q

What key neurotransmitters are involved in mood, motivation and movement?

A

Dopamine, serotonin and noradrenaline.

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14
Q

T or F
Each neurotransmitter is distinct in its structure and receptors.

A

T

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15
Q

Why does cocaine cause euphoric effects?

A

Cocaine is a drug that can inhibit neurotransmitter transporters, thus increasing synaptic concentrations of neurotransmitters.

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16
Q

T or F
Most synapses have an “auto-receptor”

A

F
All of them do

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17
Q

The various stages of sleep are generally defined based on…

A

eye movements

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18
Q

In adults, REM sleep takes up approximately …% of total sleep

A

25%

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19
Q

What is REM sleep rebound?

A

A compensatory increase in the frequency, depth, and intensity of REM sleep following sleep deprivation or significant stressors.

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20
Q

We might spend …% of our night’s sleep in NREM Stage 2.

A

50%

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21
Q

NREM Stage … is a time of recovery from toxins in the brain and may only last for a total of 40 minutes.

A

3

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22
Q

in NREM Stage …, our body prepares for deep sleep with a slowing of heart rate and a decrease in body temperature.

A

2

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23
Q

Time spent in NREM stages … and … decreases with age.

A

3 and 4

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24
Q

…% of the adult population struggles with insomnia

A

35%

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25
Q

List some things that can cause insomnia.

A

Stress, pregnancy, lifestyle factors, mental health disorders, irregular sleep schedules, age, neurological disorders, physical pain, medications and other sleep disorders.

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26
Q

What is the major inhibitory neurotransmitter in the CNS?

A

GABA (gamma-aminobutyric acid)

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27
Q

GABA is made from … using enzymatic steps

A

glutamine

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28
Q

T or F
Both ionotropic and metabotropic receptors have inhibitory consequences if activated by GABA.

A

T

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29
Q

What two main receptor types does GABA have?

A

ionotropic and metabotropic

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30
Q

… convert GABA to glutamine for movement back to the neuron.

A

Astrocytes

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31
Q

GABA is synthesized in the pre-synaptic terminal from glutamate by ….

A

glutamic acid decarboxylase (GAD).

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32
Q

GABA is then recruited into synaptic vesicles via the action of ….

A

vesicular GABA transporter (vGAT).

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33
Q

Released GABA is cleared from the synapse by membrane-bound ….

A

GABA transporters (GATs)

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34
Q

In astrocytes, GABA is recycled into synaptic vesicles or taken up by mitochondria, where it is metabolized by …. to glutamine for neuronal uptake.

A

GABA transaminase (GABA-T)

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35
Q

GABAA receptors have a central pore that is permeable to negatively charged …. following activation by GABA.

A

chloride ions

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36
Q

T or F
While most GABAA receptors have two alphas, and two betas, the fifth subunit can vary.

A

T

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37
Q

60% of GABAA receptors are in the α…β…γ… configuration.

A

α1β2γ2

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38
Q

T or F
Ethanol, benzodiazepines and barbiturates work by activating GABAA receptors.

A

F
Each of these compounds do not activate the GABAA receptor themselves, but when they are bound, they enhance the response of the GABAA receptor to GABA itself.

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39
Q

What are positive allosteric modulators?

A

compounds that enhance receptors’ structural responses in a positive or favourable way.

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40
Q

An ideal anti-insomnia medication is one that can…

A

be a potent sedative at night with limited to no remaining sedation during daytime.

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41
Q

Depending on concentration, benzodiazepines can cause what 4 effects?

A
  1. hypnosis (sleep-inducing)
  2. anaesthesia
  3. anticonvulsant
  4. muscle-relaxing effects.
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42
Q

T or F
Overdose via benzodiazepines due to respiratory or nervous system depression is rare.

A

T
That said, a combination of benzodiazepines with other agents that cause respiratory depression can be fatal.

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43
Q

T or F
What must patients avoid when taking benzodiazepines to avoid respiratory depression?

A

Alcohol and opioids.

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44
Q

Why can a combination of alcohol and benzodiazepines cause respiratory depression?

A

Both benzodiazepines and alcohol are positive allosteric modulators at GABAA receptors.

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45
Q

T or F
Benzodiazepines can be addictive

A

F
But patients may build tolerance or dependence to them.

46
Q

What class of drugs is likely to cause REM rebound when discontinued?

A

Benzodiazepines

47
Q

T or F
Benzodiazepines may suppress REM sleep.

A

T

48
Q

T or F
Zolpidem can cause REM rebound when discontinued.

A

F

49
Q

T or F
Zolpidem in not a benzodiazepine

A

T
Though it is benzodiazepine-like

50
Q

T or F
The hypnotic effects of benzodiazepines are concentration-dependent.

A

T

51
Q

There are at least … different alpha subunits comprising the GABAA receptor.

A

six (α1-6)

52
Q

There are at least … different beta subunits comprising the GABAA receptor.

A

three (β1-3)

53
Q

List the 5 different types of subunits comprising the GABAA receptor.

A

Alpha
Beta
Gamma
Sigma
Epsilon

54
Q

(Regarding GABAA receptors) Benzodiazepines have an affinity for all forms of …-subunits

A

alpha

55
Q

T or F
Benzodiazepines produce different effects depending on which GABAA subunit is activated.

A

T

56
Q

Benzodiazepine induced sedation and amnesia is mediated through the …-… subunit of GABAA receptors.

A

α1

57
Q

What is the most commonly distributed GABAA receptor subunit throughout the brain?

A

α1

58
Q

Sleep and relief from anxiety are medicated by GABAA receptor complexes with … and … subunits.

A

α2 and α3

59
Q

T or F
Z-hypnotics can be used to treat anxiety as well as insomnia.

A

F
Z-hypnotics are only used to treat insomnia.

60
Q

The inhibitory effects of Z-hypnotics on GABAA receptors are reversible in the presence of … as an antagonist.

A

flumazenil

61
Q

The Z-hypnotics interact with GABAA receptors containing … subunits.

A

gamma (γ)

62
Q

Zolpidem medicates its effects mostly via the … containing GABAA receptors.

A

α1

63
Q

Zolpidem medicates its effects partially through … and … subunits.

A

α2 and α3

64
Q

Zolpidem has very little affinity for … subunits on GABAA receptors.

A

α5

65
Q

T or F
Benzodiazepines have a comparatively short half-life compared to Z-hypnotics.

A

F
vice versa

66
Q

T or F
Between benzodiazepines and Z-hypnotics, benzodiazepines carry the greatest risk of abuse potential and development of tolerance.

A

T

66
Q

T or F
Zolpidem is not generally used for anticonvulsant effects, as it is less effective than benzodiazepines at this.

A

T

67
Q

The Z-hypnotic with the longest duration of action is…

A

Zopiclone

68
Q

T or F
Eszopiclone has a more rapid onset of action when compared with zopiclone.

A

T

69
Q

Our physiological mechanism for aligning hormonal levels and processes with our environment is largely driven by …. during a 24-hour period.

A

our exposure to light and dark

70
Q

Physical light is perceived by the … and passed via the …. to the …..

A

retina
optic nerve
occipital cortex

71
Q

The brains … is where light cues from the environment are received.

A

suprachiasmatic nucleus (SCN)

72
Q

Melatonin is a hormone produced by the … of the brain.

A

pineal gland

73
Q

T or F
Melatonin secretion decreases in darkness and increases during light exposure.

A

F
Vice versa.

74
Q

When prompted by darkness what does melatonin do to promote sleep?

A

lowers body temperature and contributes to drowsiness.

75
Q

The function of melatonin is timed by the …. of the hypothalamus.

A

suprachiasmatic nucleus

76
Q

T or F
Melatonin is an agonist for at least three receptor types.

A

T

77
Q

What receptor types does melatonin agonize?

A

MT1, MT2 and MT3.

78
Q

T or F
MT2 and MT3 are both GPCRs.

A

F
MT1 and MT2 are GPCRs.

79
Q

When MT1 and MT2 are activated they inhibit the enzyme …. which leads to a reduction in …

A

adenylyl cyclase
cAMP

80
Q

What can MT1 receptors activate?

A

MT1 receptors can also activate phospholipase C (PLC).

81
Q

Other than inhibiting adenylyl cyclase and reducing cAMP what else can MT2 receptors inhibit and reduce?

A

guanylyl cyclase and reduces cGMP formation.

82
Q

T or F
Melatonin is made exclusively in the pineal gland.

A

F
It is also locally synthesised in the retina and gastrointestinal tract.

83
Q

Outside of the pineal gland what effects is melatonin thought to have?

A

Melatonin is also thought to function primarily as an antioxidant in the GIT and retina.

84
Q

The actions of melatonin can be mimicked by the binding of …

A

agomelatin

85
Q

Agomelatin is a … and … receptor agonist.

A

M1 and M2

86
Q

What is narcolepsy?

A

A sleep disorder characterized by feeling extreme sleepiness every day; vivid hallucinations, sleep paralysis, cataplexy, and disrupted and fragmented sleep).

87
Q

What causes narcolepsy?

A

When hypocretin neurons die off in the hypothalamus. The cause is unknown, though an autoimmune disorder is suspected.

88
Q

Hypocretin neurons produce … and …

A

hypocretin-1 and hypocretin-2
(also called orexin A and B)

89
Q

How does hypocretin-1 and hypocretin-2 (aka orexin A and B) susatin wakefulness?

A

by activating neurons throughout the brain.

90
Q

What two receptors in the CNS are involved in the effects of the hypocretins?

A

hctr1 and hctr2.

91
Q

Hypocretin neurons stimulate … neurons and increase their rate of firing.

A

histaminergic

92
Q

Of the histamine receptors in the body, … activation leads to a sedative effect.

A

H1R

93
Q

Presynaptic … have inhibitory effects when activated by histamine, leading to a reduction in histamine release and synthesis.

A

H3Rs

94
Q

H3Rs are “constitutively active”, meaning…

A

that they have efficacy even in histamine’s absence.

95
Q

What is cataplexy?

A

A syptom of Narcolepsy often triggered by strong emotions, results in the patient not being able to control their muscles. Patients are unable to move for 30 sec to 2 min. In severe attacks, the patient may fall and experience paralysis for several minutes, being fully aware of what is happening

96
Q

Narcolepsy type 1 is characterised by…

A

cataplexy and low levels of hypocretin

97
Q

Narcolepsy type 2 is characterised by…

A

cataplexy and normal levels of hypocretin.

98
Q

… is the R-isomer of modafinil.

A

Armodafinil

99
Q

T or F
Armodafinil has been shown to have a longer duration of effect in patients compared to modafinil.

A

T

100
Q

Elevated concentrations of dexamphetamine can inhibit … enzyme activity.

A

MAO

101
Q

T or F
The urge to move one’s legs is the main symptom of restless legs syndrome.

A

T

102
Q

T or F
Most drugs prescribed to treat RLS aren’t recommended during pregnancy.

A

T

103
Q

What are the three types of sleep apnoea?

A

Obstructive sleep apnoea
Central sleep apnoea
Complex sleep apnoea

104
Q

What is the most common type of sleep apnoea?

A

Obstructive sleep apnoea

105
Q

What is sleep apnoea?

A

A condition in which breathing repeatedly pauses or becomes shallow or infrequent during sleep, often with loud snoring.

106
Q

What are some associated risk factors for central sleep apnoea?

A

congestive heart failure, being a middle-aged to older male, a previous stroke, using opioid medications.

107
Q

What causes central sleep apnoea?

A

when the the brain is not correctly regulating the muscles involved in breathing.

108
Q

What lifestyle changes can be implemented to treat obstructive sleep apnoea?

A

Losing weight, smoking.

109
Q

T or F
CPAP devices are not as effective as surgery for the treatment of sleep apnoea.

A

F
Surgery is not thought to be as effective as CPAP devices.

PHRM2101 (12 decks)

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