anxiety and sleep

Question 1

describe the action of the GABA channel

Answer 1

ligand gated Cl channel

opening = Cl influx, resulting in hyper polarization

Question 2

what is the difference between the action of barbiturates and benzodiazepines on GABA channel?

Answer 2

barb- increase duration of opening

bzd- increase frequency of opening

Question 3

4 substances that have receptors on GABA channel

Answer 3

GABA
ethanol
benzos
barbituates

Question 4

effect of BZDs on sleep

Answer 4

shortens REM

extends stage 1/2 NREM

Question 5

which benzo are preferred in the elderly? why?

Answer 5

LOT (lorazepam, oxazepam, temazepam), do not do through desmethyldiazepam intermediate

Question 6

treat benzo overdose with

Answer 6

flumazenil

Question 7

m/s SE of benzos

Answer 7

drowsiness, sedation

Question 8

effect of GABA-A receptor agonists on sleep

Answer 8

decrease sleep latency
increase total sleep
no effect on REM at normal doses

Question 9

what are the GABA-A drugs?

Answer 9

the Z drugs (zolpidem, zaleplon, eszopiclone)

Question 10

which of the Z drugs is only approved for short term use?

Answer 10

zaleplon

Question 11

MOA of ramelteon

Answer 11

agonist of melatonin receptor types 1/2

Question 12

MOA of buspirone

Answer 12

partial 5HT1A agonist

Question 13

benefits of buspirone over BZD

Answer 13

little risk of abuse/dependence
will not interact with alcohol
no CNS depression/psychomotor effects

Question 14

why is alcohol not preferred for sleep?

Answer 14

will induce sleep, but can be followed by rebound excitation (ultimately disrupts sleep and can cause long term depression)