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Flashcards in Sleep Deck (12)
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1
Q

What are the alerting neurotransmitters?

A

Histamine, serotonin and norepinephrine

2
Q

What is the role of the ventral lateral pre optic nucleus (VLPO) of the hypothalamus?

A

Activated –> Releases GABA –> sedates alerting chemicals

3
Q

What is orexin?

A

Peptide produced in hypothalamus that promotes wakefulness; suvorexant = orexin blocker

4
Q

What is the two-process model to explain the sleep-wake cycle?

A

(1) Homeostatic drive to sleep –> driven by sleep debt (increases with duration of waking)
(2) Circadian rhythms

5
Q

What is the role of the suprachiasmatic nucleus?

A

SCN activity promotes arousal during the day via alerting neurotransmitters and allows normal sleep at night

6
Q

What is the role of melatonin in sleep?

A

It is produced by the brain at night –> allows our drive to sleep to take over

7
Q

How would you describe REM Behavior Disorder?

A

Dreaming without muscle paralysis

8
Q

What are the non-BZ hypnotics? What is their mechanism of action?

A

Zolpidem, Zalepon, Eszopiclone; interact with BZ receptor on GABA receptor (most commonly prescribed)

9
Q

What are a few major classes of medications known to cause insomnia?

A

Steroids
Anti-depressants
Bronchodilators
Levadopa

10
Q

Name the sedating anti-depressants

A

Doxepin (TCA)
Mirtazipine (atypical antidepressant)
Trazadone (atypical antidepressant)
Amytriptyline (TCA)

11
Q

Why do we generally stay away from prescribing benzodiazapines for insomnia?

A

Dependence and withdrawal

Anterograde amnesia

12
Q

What are the 4 characteristics of narcolepsy?

A

Excessive daytime sleepiness
Sleep paralysis (REM but mind is aroused)
Cataplexy (loss of muscle tone due to strong emotion)
Hypnagogic / hypnapompic hallucinations