Sleep Aids_Jobin Kalathil

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  • A sleep disorder (somnipathy) is a disorder in the sleep patterns of a person or animal. Some sleep disorders can interfere with mental and emotional function. A test commonly ordered for some sleep disorders the polysomnogram .
  • Both organic and nonorganic insomnia constitute a sleep disorder . It is often caused by fear , stress , anxiety , medications , herbs , caffeine , depression or sometimes for no apparent reason. An overactive mind or physical pain may also be causes.
  • have a carbonyl group at position 2. The first of these is another benzene ring, separated from the heterocyclic benzodiazepine ring system by a single bond. A benzene ring is called a phenyl group when it is part of a larger molecule. There is one final requirement, without which our beautiful molecule will have no drug effect. There must be an electron-attracting substituent at position 7. The halogens ミ chlorine, flourine, bromine, and iodine ミ are nice attractors of electrons, which is to say, they are quite electronegative atoms (flourine, in fact, is the most electronegative of all elements).
  • Benzodiazepines produce their variety of effects by depressing the central nervous system and by modulating the GABA A receptor, the most prolific inhibitory receptor within the brain. Once bound, the benzodiazepine locks the GABA A receptor into a conformation where the neurotransmitter GABA has much higher affinity for the GABA A receptor, increasing the frequency of opening of the associated Chloride ion channel and hyperpolarizing the membrane. This potentiates the inhibitory effect of the available GABA leading to sedatory and anxiolytic effects. As mentioned, different benzodiazepines can have different affinities for GABA A receptors made up of different collection of subunits. For instance, benzodiazepines with high activity at the α 1 are associated with sedation whereas those with higher affinity for GABA A receptors containing α 2 and/or α 3 subunits have good anti-anxiety activity.
  • nonbenzodiazepine hypnotic that potentiates gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to benzodiazepine type 1 (BZ1) receptors.
  • Certain medications may worsen RLS in those who already have it, or cause it secondarily. These include: anti-nausea drugs , certain antihistamines (often in over-the-counter cold medications), drugs used to treat depression (both older tricyclics and newer SSRIs ), antipsychotic drugs, and certain medications used to control seizures . Some people find it is worsened by the consumption of diet soda , alcohol , or caffeine . Hypoglycemia has also been found to worsen RLS symptoms. For those affected, a reduction or elimination in the consumption of simple carbohydrates (for example, sugar, white flour, white rice and white potatoes) is recommended.Both primary and secondary RLS can be worsened by surgery of any kind, however back surgery or injury is often associated with causing RLS. RLS often worsens in pregnancy . dopamine agonist , manufactured by GlaxoSmithKline Mechanism of Action: REQUIP is a non-ergoline dopamine agonist with high relative in vitro specificity and full intrinsic activity at the D2 and D3 dopamine receptor subtypes, binding with higher affinity to D3 than to D2 or D4 receptor subtypes. Ropinirole has moderate in vitro affinity for opioid receptors. Ropinirole and its metabolites have negligible in vitro affinity for dopamine D1, 5-HT1, 5-HT2, benzodiazepine, GABA, muscarinic, alpha1-, alpha2-, and beta-adrenoreceptors.
  • The exact mechanism of action is not well understood, however it is generally thought that tricylic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine , dopamine , or serotonin by nerve cells . Tricyclics may also possess an affinity for muscarinic and histamine H1 receptors to varying degrees. Although the pharmacologic effect occurs immediately, often the patient's symptoms do not respond for 2 to 4 weeks
  • Sleep Aids_Jobin Kalathil

    1. 1. Sleep Aids By Jobin S. Kalathil
    2. 2. Sleep Orders of Interest: <ul><li>Insomnia : is characterized by the inability to fall asleep and/or remain asleep for a reasonable amount of time. </li></ul><ul><li> Restless legs syndrome (RLS): is characterized by an irresistible urge to move legs while sleeping. </li></ul><ul><li>Bed wetting : is associated with the involuntary passing of urine while asleep; after the age at which bladder control would normally be anticipated. </li></ul>
    3. 3. General Principles of Treatment: <ul><li>Treatments for sleep disorders can be grouped into three general categories: </li></ul><ul><li>1) behavioral/ psychotherapeutic treatments </li></ul><ul><li>2) medications </li></ul><ul><li>3) other somatic treatments (like surgery) </li></ul>
    4. 4. Insomnia <ul><li>The three types of insomnia are: </li></ul><ul><li>1) Transient insomnia </li></ul><ul><li>2) Acute Insomnia </li></ul><ul><li>3) Chronic Insomnia </li></ul>
    5. 5. Medications: <ul><li>The most commonly used drugs are: </li></ul><ul><li>Benzodiazepines </li></ul>http://www.etfrc.com/benzos1.htm Commonly prescribed benzodiazepines include: temazepam, diazepam, lorazepam, flurazepam, nitrazepam and midazolam
    6. 7. Non-benzodiazepine prescription drugs <ul><li>Ambien </li></ul>Lunesta
    7. 8. <ul><li>Selectively binds to the melatonin receptors instead of GABA receptors. </li></ul>Rozerem
    8. 9. Restless Leg Syndrome <ul><li>Requip </li></ul>http://www.neurosci.pharm.utoledo.edu/MBC3320/images/Ropinirole.gif
    9. 11. Bed wetting <ul><li>Two main types of drugs prescribed: </li></ul><ul><li>Tricyclic antidepressant prescription drugs (e.g. Amitriptyline, Imipramine or Nortriptyline) </li></ul>
    10. 12. Bed wetting <ul><li>Desmopressin </li></ul>
    11. 13. Works Cited <ul><li>&quot;Cognitive Behavior Therapy and Pharmacotherapy for Insomnia.&quot; Archives of Internal Medicine 164. 16 Mar. 2007 <http://archinte.amaassn.org/cgi/content/abstract/164/17/1888>. </li></ul><ul><li>Griffiths, Rr, M.w Johnson, and P.e Suess. &quot;Ramelteon: a Novel Hypnotic Lacking Abuse Liability and Sedative Adverse Effects.&quot; </li></ul><ul><li>&quot;Mechanism of Action.&quot; Requip . 13 Mar. 2007 <http://www.requip.com/pd/hcp/mechanism_of_action.html> </li></ul><ul><li>Archives of General Psychiatry 63 (2006): 1149-1157. EBSCO. SMU. 12 Mar. 2007. National Institute of Health. Ambien . 12 Mar. 2007 <http://dailymed.nlm.nih.gov/dailymed/fdaDrugXsl.cfm?id=635&type=display>. </li></ul><ul><li>&quot;New Drug Offers Relief From Chronic Insomnia.&quot; Cortlandt Forum 19 (2006): 22. EBSCO. SMU. </li></ul>
    12. 14. <ul><li>&quot;New Evidence That the Pharmacological Effects of Benzodiazepine Receptor Ligands Can Be Associated with Activities At Different BZ (?) Receptor Subtypes.&quot; Psychopharmachology . PubMed.Gov. 12 Mar. 2007. </li></ul><ul><li>Office of Communications and Public Liaison. National Institute of Neurological Disorders and Stroke. Restless Legs Syndrome Fact Sheet . 14 Feb. 2007. 12 Mar. 2007 <http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm#84783237>. </li></ul><ul><li>&quot;PRAMIPEXOLE/ROPINIROLE.&quot; National Institute of Neurological Disorders and Stroke . 11 Mar. 2007 <http://www.ninds.nih.gov/funding/research/parkinsonsweb/drug_summaries/pramipexole.htm>. </li></ul><ul><li>&quot;Requip.&quot; GlaxoSmithKline . 11 Mar. 2007 <http://us.gsk.com/products/assets/us_requip.pdf>. </li></ul>
    13. 15. <ul><li>&quot;REQUIP.&quot; http://www.requip.com/ . GlaxoSmithKline. 15 Mar. 2007 <http://us.gsk.com/products/assets/us_requip.pdf>. </li></ul><ul><li>&quot;Restless Legs Syndrome.&quot; Wikepedia . 14 Mar. 2007 <http://en.wikipedia.org/wiki/Restless_legs_syndrome>. </li></ul><ul><li>&quot;Rozerem.&quot; Wikipedia . 10 Mar. 2007 <http://en.wikipedia.org/wiki/Rozerem>. &quot;Sleep Disorders.&quot; Wikipedia . 9 Mar. 2007 <http://en.wikipedia.org/wiki/Sleep_disorder>. </li></ul>
    14. 16. Wake Up

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