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NE2 Insomnia

Usuario eliminado 11 preguntas Actualizado el 11 oct 2019

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Preguntas del test (11)

  1. 1Sleep Hygiene: ASLEEP
    • Avoid [blank_start]alcohol, caffeine and nicotine[blank_end]
    • [blank_start]Sleep (and sex)[blank_end] should be the only use of the bed
    • Leave [blank_start]laptops, TVs and paperwork[blank_end] out of the bedroom
    • [blank_start]Exercise[blank_end] regularly and be outdoors during the day
    • Early rising - avoid [blank_start]sleeping in and daytime naps[blank_end]
    • Plan for bedtime
    1. Aalcohol, caffeine and nicotine
    2. BSleep (and sex)
    3. Claptops, TVs and paperwork
    4. DExercise
    5. Esleeping in and daytime naps
  2. 2Lack of sleep
    • Irritability
    • [blank_start]Daytime[blank_end] sleepiness
    • [blank_start]Low[blank_end] energy/motivation
    • Physical discomfort
    • Impaired [blank_start]cognitive function[blank_end]
    1. ADaytime
    2. BLow
    3. Ccognitive function
  3. 3Insomnia - “Repeated inability to initiate and maintain sleep.”
    - Transient, [blank_start]2-3[blank_end] days - likely cause [blank_start]acute[blank_end] situational or environmental stress (shift work, jet lag)
    - Short term, <[blank_start]3[blank_end] weeks - likely cause [blank_start]ongoing[blank_end] personal stress
    - Long term, >3 weeks - likely causes psychiatric illness, behavioural, medical reasons
    1. A2-3
    2. B3
    3. Cacute
    4. Dongoing
  4. 4Neurotransmitter effects:
    1. Cortical arousal regulated by - (match NT to location)
    [blank_start]Noradrenaline[blank_end] (locus coeruleus)
    [blank_start]Cholinergic[blank_end] pathways (brainstem)
    [blank_start]Histamine[blank_end] (tuberomamillary nucleus)
    [blank_start]Serotonin[blank_end] (raphe nucleus)

    2. Promote wakefulness: orexins/hypocretins ([blank_start]peptide neurotransmitters[blank_end])

    3. Sleep induced by: [blank_start]GABA, melatonin and galanin[blank_end]
    1. ANoradrenaline
    2. BCholinergic
    3. CHistamine
    4. DSerotonin
    5. Epeptide neurotransmitters
    6. FGABA, melatonin and galanin
  5. 5GABA
    - Gamma-aminobutyric acid, major inhibitory neurotransmitter, decreases [blank_start]neuronal excitability[blank_end] and therefore CNS function
    - Drugs potentiating GABA [blank_start]transmission[blank_end]
    1. Hypnotic ([blank_start]sleep inducing[blank_end] properties)
    2. Sedative (moderating excitement and [blank_start]calming[blank_end])
    3. [blank_start]Anxiolytic[blank_end] (anxiety-relieving)
    1. Aneuronal excitability
    2. Btransmission:
    3. Csleep inducing
    4. Dcalming
    5. EAnxiolytic
  6. 6Drag and drop pharmacotherapies people take for insomnia into the right boxes.Imagen de la pregunta 6
    1. ADietary supplements
    2. BOTC/sleep aids
    3. CSedating medications
    4. DInsomnia meds
  7. 7Benzodiazepine receptor agonists e.g. [blank_start]triazolam, temazepam[blank_end].
    Indicated for acute insomnia.
    • Dose related [blank_start]hypnotic[blank_end] effects
    • Facilitate [blank_start]onset and duration[blank_end] of sleep
    • Alter NREM:REM
    • [blank_start]Rebound[blank_end] insomnia
    • Caution in pulmonary/respiratory disease: [blank_start]respiratory and CV[blank_end] depression risk.
    1. Atriazolam, temazepam
    2. Bhypnotic
    3. Conset and duration
    4. DRebound
    5. Erespiratory and CV
  8. 8Pharmacodynamics of benzos:
    - [blank_start]Positive allosteric[blank_end] modulator of GABA(A) R (most [blank_start]abundant[blank_end] R in CNS)
    - ‘[blank_start]tonic[blank_end]’ inhibition
    - [blank_start]hyper[blank_end]polarisation via Cl-
    - makes excitation [blank_start]less[blank_end] likely

    Pharmacokinetics of benzos:
    - Potency: hydrophobicity
    - Plasma protein [blank_start]binding[blank_end] (less free drug concentration).. so less potency in vivo
    - E.g.: [blank_start]Diazepam[blank_end] - rapid onset, long acting, vs [blank_start]midazolam[blank_end] rapid onset, short acting, temazepam and triazolam very [blank_start]short[blank_end] half life, nitrazepam [blank_start]long[blank_end] half life
    - Caution: increased potency with low [blank_start]albumin[blank_end] (e.g. haemodilution, liver dysfunction)
    - Metabolised by CYP3A4 (Caution: impaired [blank_start]hepatic[blank_end] function)
    1. APositive allosteric
    2. Babundant
    3. Ctonic
    4. Dhyper
    5. Eless
    6. Fbinding
    7. GDiazepam
    8. Hmidazolam
    9. Ishort
    10. Jlong
    11. Kalbumin
    12. Lhepatic
  9. 9Non-benzodiazepine hypnotics: zalepon, zolpidem, zopiclone
    • [blank_start]Different[blank_end] chemical class, similar mechanism
    • Postsynaptic GABA(A) Rs - binding site [blank_start]distinct[blank_end] from benzo site
    • Increased [blank_start]Cl- influx[blank_end] causes hyperpolarisation
    • Rapidly [blank_start]absorbed[blank_end], metabolized by liver
    • Short t1/2 ~ [blank_start]1-6[blank_end]h

    Unwanted effects: Incoordination, drowsiness, dizziness, confusion, amnesia
    1. ADifferent
    2. Bdistinct
    3. CCl- influx
    4. Dabsorbed
    5. E1-6
  10. 10Benzos and Zs have problems as short term and long-term therapy:
    [blank_start]Sedation, drowsiness, muscle relaxation[blank_end] - affects driving, machinery operation, [blank_start]falls[blank_end] in elderly
    [blank_start]Abusable[blank_end] (rapid onset, short duration, high potency) and dependence risks.
    1. ASedation, drowsiness, muscle relaxation
    2. Bfalls
    3. CAbusable

Información

Descripción
El usuario ha eliminado su información de asignaturas Test sobre NE2 Insomnia, creado por Usuario eliminado el 11/10/2019.
Autor
Usuario eliminado
Idioma
English
Visitas
105
Historial
Creado el 11 oct 2019 · actualizado el 11 oct 2019
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