Thuốc ngủ và thuốc an thần pps

The period of twenty-four The period of twenty-four hours formed by the regular hours formed by the regular revolution of our Earth is revolution of our Earth is apparent in all diseases It apparent in all diseases It is, as it were, the unit of is, as it were, the unit of our natural chronology. our natural chronology. — Christopher William — Christopher William Hufeland, 1796 Hufeland, 1796 SUPRACHIASMATIC NUCLEUS BMAL1:Aryl hydrocarbon receptor nuclear translocator-like CLOCK: Circadian Locomotor Output Cycles Kaput Bmal (brain and muscle aryl hydrocarbon receptor nuclear translocator (ARNT)-like) CK1ε : casein kinase 1ε Rhythm of waking (blue lines) and sleeping (red lines) of a volunteer Rhythm of waking (blue lines) and sleeping (red lines) of a volunteer in an isolation chamber with and without cues about the day-night in an isolation chamber with and without cues about the day-night cycle. Numbers represent the mean ± standard deviation of a complete cycle. Numbers represent the mean ± standard deviation of a complete waking/sleeping cycle during each period (blue triangles represent waking/sleeping cycle during each period (blue triangles represent times when the rectal temperature was maximum). (After times when the rectal temperature was maximum). (After Aschoff, 1965 Aschoff, 1965 , , as reproduced in Schmidt et. al., 1983.) as reproduced in Schmidt et. al., 1983.) CRY CRY (cryptochrome (cryptochrome ), CLOCK (C) ( ), CLOCK (C) ( Circadian locomotor output Circadian locomotor output cycles kaput cycles kaput ), BMAL1 (B) ( ), BMAL1 (B) ( brain and muscle, ARNT-like brain and muscle, ARNT-like ), PER1 ), PER1 ( ( Period1 Period1 ), PER2 ( ), PER2 ( Period2 Period2 ), PER3 ( ), PER3 ( Period3 Period3 ), and ), and vasopressin vasopressin prepropressophysin (VP) ( prepropressophysin (VP) ( clock controlled clock controlled genes genes ; ccg ; ccg ) ) Anatomical underpinnings of Anatomical underpinnings of circadian rhythms circadian rhythms . . (A) (A) The The hypothalamus hypothalamus , showing the location of , showing the location of the the suprachiasmatic nucleus suprachiasmatic nucleus (SCN), which in (SCN), which in mammals mammals is the primary “biological clock.” The is the primary “biological clock.” The name “suprachiasmatic” derives from the name “suprachiasmatic” derives from the location of the nucleus just above the location of the nucleus just above the optic chiasm optic chiasm . . (B) (B) Diagram of the pathway from the Diagram of the pathway from the suprachiasmatic nucleus suprachiasmatic nucleus to the to the pineal gland pineal gland . . Activation Activation of specific neural circuits triggers sleep and wakefulness. of specific neural circuits triggers sleep and wakefulness. (A) (A) Electrical stimulation of the Electrical stimulation of the cholinergic cholinergic neurons neurons near the junction of near the junction of pons pons and midbrain (the and midbrain (the reticular activating system reticular activating system ) causes a sleeping cat ) causes a sleeping cat to awaken. to awaken. (B) (B) Electrical stimulation of the Electrical stimulation of the thalamus thalamus causes an awake cat to fall causes an awake cat to fall asleep. Graphs show EEG recordings before and during stimulation. asleep. Graphs show EEG recordings before and during stimulation. [...]... (EOG) and the lower panels show changes in various muscular and autonomic functions Movement of neck muscles was measured using an electromyogram (EMG) Other than the few slow eye movements approaching stage I sleep, all other eye movements evident in the EOG occur in REM sleep The greatest EMG activity occurs during the onset of sleep and just prior to awakening The heart rate (beats per minute) and... minute) slow in non-REM sleep, but increase almost to the waking levels in REM sleep Finally, penile erection occurs only during REM sleep (After Schmidt et al., 1983.) CÁC NHÓM THUỐC NGỦ AN THẦN HiỆN HÀNH CÁC NHÓM THUỐC NGỦ AN THẦN HiỆN HÀNH 1 BENZODIAZEPINES: diazepam, midazolam ect… 1 BENZODIAZEPINES: diazepam, midazolam ect… 2 BARBITURATES: phenobarbital, ect… 2 BARBITURATES: phenobarbital, ect… 3... GiẤC NGỦ CHU KỲ GiẤC NGỦ RAPID EYES MOVEMENT SLEEP RAPID EYES MOVEMENT SLEEP Physiological changes in a male volunteer during the various sleep states in a typical 8-hour period of sleep (A) The duration of REM sleep increases from 10 minutes in the first cycle to up to 50 minutes in the final cycle; note that slow-wave (stage IV) sleep is attained only in the first two cycles (B) The upper panels . panels show the cycles. (B) The upper panels show the electro-oculogram (EOG) and the lower electro-oculogram (EOG) and the lower panels show changes in various muscular panels show changes. this plane of section. shown in this plane of section.