Narcolepsy genetic predisposition to misbalance of

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Narcolepsy: Genetic predisposition to misbalance of neuromediators(incr. concentration of GABA). Primary condition or consequence of psychotic disorders, treatment with psychotic drugs, drug addicts, in daytime-pathological sleepiness, in nighttime, insomnia. Occurs with hallucinations: -hypnogogic-when patient is falling asleep -hypnopompic- when patient is waking up There is sleep paralysis, means when patient is waking up has severe diffuse weakness of muscles. Kataplexy- short-lasting episodes of diffuse muscle weakness (sudden, occurs only during alert state) Diagnosis: -Electroencephalography -Polysomnography-EEG during sleep Treatment: - Psychostimulators: amphetamine drugs(Doxamphetamine, Mthylphenidate, Modafenil) - Antidepressants- Fluoxetine, Milipromine, Fluoxamine - Prolonged treatment, several months, 1 year or longer Insomnia: Chronic or paroxysmal condition Types:
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-primary: impossible to associate with any disorder -secondary: disease associated: psychotic, somatic, neurological, any disease may produce insomnia Diagnosis: depends on involved part of sleep EEG- to confirm type of insomnia Treatment: - Benzodiazepines:Alprazolam, Lorazepam, Diazepam Half-life of drug should be considered, short lastin are usefull in sleep initiation, long lasting in keeping o sleep. Used only 1-2 months due to high dependence risk - Hypnotics: Zopiclone, Zaleptone Don’t affect benzodiazepine receptor- lower potential of dependence, can be used longer - Antihistamines- H1 receptor blocker, used for short term management f.e. due to pain after surgery - Neuroleptics- drugs off last choice, associated with psychotic diseases(delirium). Sulpiride - Chronic insomnia: - Sedating inhibiting antidepressants. TCA’s- Amitryptyline, Doxepin --------------------------------------------FABIAN---------------------------------------------------------------------------------------------- 14. Autonomic crisis (panic attack) *Causes: -Withdrawal from a drug or alcohol -depression -Phobias – People will often experience panic attacks as a direct result of exposure to a phobic object or situation. -Short-term triggering causes: Significant personal loss, including an emotional attachment to a romantic partner, life transitions, significant life change. -Hyperventilation syndrome can cause respiratory alkalosis and hypocapnia . This causes a cluster of symptoms, including rapid heart beat , dizziness , and light-headedness , which can trigger panic attacks. -Situationally bound panic attacks – Associating certain situations with panic attacks, due to experiencing one in that particular situation can lead to an episode -Chronic and/or serious illness Cardiac conditions that can cause sudden death for example) -Discontinuation or marked reduction in the dose of a drug (antidepressant etc) *mechanisms -first, there is frequently (but not always) the sudden onset of fear with little provoking stimulus -this leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response -this leads to an increased heart rate ( tachycardia ), rapid breathing ( hyperventilation ) which may be perceived as shortness of breath ( dyspnea ), and sweating (which increases grip and aids heat loss) -the hyperventilation leads to a drop in carbon dioxide levels in the
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  • Winter '18
  • Jane doe

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