Belsomra

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<StructureSection load='4S0V' size='340' side='right' caption='Caption for this structure' scene=''>
<StructureSection load='4S0V' size='340' side='right' caption='Caption for this structure' scene=''>
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This is a default text for your page '''Belsomra'''. Click above on '''edit this page''' to modify. Be careful with the &lt; and &gt; signs.
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You may include any references to papers as in: the use of JSmol in Proteopedia <ref>DOI 10.1002/ijch.201300024</ref> or to the article describing Jmol <ref>PMID:21638687</ref> to the rescue.
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<scene name='74/746099/Belsomra/1'>Belsomra</scene>, also known as Suvorexant, is a medication used to treat insomnia. <ref name="one">Aschenbrenner, DS. First Orexin Receptor Antagonist Approved for Insomnia. AJN, American Journal of Nursing. 2014 Dec;114(12):26. doi: 10.1097/01.NAJ.0000457406.61092.35. </ref>. While most other insomnia drugs, like Ambien and Lunesta, are GABA agonists and work to slow down neuronal firings, Belsomra is the first drug to target orexin <ref>doi: 10.1017/S1092852916000225</ref>. Orexin, also known as hypocretin, is a neurotransmitter that binds to receptors in order to cause alertness and wakefulness. By targeting these neurotransmitters, it cuts off the signals causing one to be awake, and will result in sleep <ref name="one" />.
<scene name='74/746099/Belsomra/1'>Belsomra</scene>, also known as Suvorexant, is a medication used to treat insomnia. <ref name="one">Aschenbrenner, DS. First Orexin Receptor Antagonist Approved for Insomnia. AJN, American Journal of Nursing. 2014 Dec;114(12):26. doi: 10.1097/01.NAJ.0000457406.61092.35. </ref>. While most other insomnia drugs, like Ambien and Lunesta, are GABA agonists and work to slow down neuronal firings, Belsomra is the first drug to target orexin <ref>doi: 10.1017/S1092852916000225</ref>. Orexin, also known as hypocretin, is a neurotransmitter that binds to receptors in order to cause alertness and wakefulness. By targeting these neurotransmitters, it cuts off the signals causing one to be awake, and will result in sleep <ref name="one" />.
== Function ==
== Function ==
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== Structural Highlights ==
== Structural Highlights ==
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<ref>doi:10.1093/database/bav120 </ref>
==Relationship to Insomnia==
==Relationship to Insomnia==
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Insomnia is a sleep disorder that is seen to be mostly caused by stress, and results in inefficient cooperation between the sleep and wake pathways of the arousal system. The branch of the arousal system that reaches the lateral hypothalamus, which contains the melanin-concentrated orexin neuropeptide signaling system, is one of the most significantly affected areas of the wakefulness network. This orexin system is a major promoter for wakefulness and is most active during efforts to sustain and maintain arousal, while showing little activity during sleep (Sutton). Orexins show little activity during sleep because the systems to promote wakefulness are blocked by neurons of the ventrolateral preoptic nucleus and thus cannot fire. During sleep, these VLPO neurons are activated and form dense clusters containing GABA and galanin, which aid in their function as inhibitors for arousal.
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Insomnia is a sleep disorder that is seen to be mostly caused by stress, and results in inefficient cooperation between the sleep and wake pathways of the arousal system. The branch of the arousal system that reaches the lateral hypothalamus, which contains the melanin-concentrated orexin neuropeptide signaling system, is one of the most significantly affected areas of the wakefulness network. This orexin system is a major promoter for wakefulness and is most active during efforts to sustain and maintain arousal, while showing little activity during sleep. Orexins show little activity during sleep because the systems to promote wakefulness are blocked by neurons of the ventrolateral preoptic nucleus and thus cannot fire. During sleep, these VLPO neurons are activated and form dense clusters containing GABA and galanin, which aid in their function as inhibitors for arousal.
With insomnia, the structures regulating a patient’s arousal system are unusually active during sleep, and thus the system fails to deactivate. Belsomra is a drug that counteracts this by serving as a dual antagonist in its interactions with Orexin receptors 1 and 2, in the aim of deactivating the arousal system in order for patients to sleep with little orexin activity present. This could also exacerbate the symptoms of narcolepsy, as the already little orexin activity would be diminished at great risk to patients with the sleep disorder.
With insomnia, the structures regulating a patient’s arousal system are unusually active during sleep, and thus the system fails to deactivate. Belsomra is a drug that counteracts this by serving as a dual antagonist in its interactions with Orexin receptors 1 and 2, in the aim of deactivating the arousal system in order for patients to sleep with little orexin activity present. This could also exacerbate the symptoms of narcolepsy, as the already little orexin activity would be diminished at great risk to patients with the sleep disorder.

Revision as of 18:58, 28 November 2016

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References

  1. Hanson, R. M., Prilusky, J., Renjian, Z., Nakane, T. and Sussman, J. L. (2013), JSmol and the Next-Generation Web-Based Representation of 3D Molecular Structure as Applied to Proteopedia. Isr. J. Chem., 53:207-216. doi:http://dx.doi.org/10.1002/ijch.201300024
  2. Herraez A. Biomolecules in the computer: Jmol to the rescue. Biochem Mol Biol Educ. 2006 Jul;34(4):255-61. doi: 10.1002/bmb.2006.494034042644. PMID:21638687 doi:10.1002/bmb.2006.494034042644
  3. 3.0 3.1 3.2 Aschenbrenner, DS. First Orexin Receptor Antagonist Approved for Insomnia. AJN, American Journal of Nursing. 2014 Dec;114(12):26. doi: 10.1097/01.NAJ.0000457406.61092.35.
  4. Stahl SM. Mechanism of action of suvorexant. CNS Spectr. 2016 Jun;21(3):215-8. doi: 10.1017/S1092852916000225. PMID:27322687 doi:http://dx.doi.org/10.1017/S1092852916000225
  5. 5.0 5.1 Krystal AD, Benca RM, Kilduff TS. Understanding the sleep-wake cycle: sleep, insomnia, and the orexin system. J Clin Psychiatry. 2013;74 Suppl 1:3-20. doi: 10.4088/JCP.13011su1c. PMID:24107804 doi:http://dx.doi.org/10.4088/JCP.13011su1c
  6. Sakurai T, Amemiya A, Ishii M, Matsuzaki I, Chemelli RM, Tanaka H, Williams SC, Richardson JA, Kozlowski GP, Wilson S, Arch JR, Buckingham RE, Haynes AC, Carr SA, Annan RS, McNulty DE, Liu WS, Terrett JA, Elshourbagy NA, Bergsma DJ, Yanagisawa M. Orexins and orexin receptors: a family of hypothalamic neuropeptides and G protein-coupled receptors that regulate feeding behavior. Cell. 1998 Feb 20;92(4):573-85. PMID:9491897
  7. Breuza L, Poux S, Estreicher A, Famiglietti ML, Magrane M, Tognolli M, Bridge A, Baratin D, Redaschi N. The UniProtKB guide to the human proteome. Database (Oxford). 2016 Feb 20;2016. pii: bav120. doi: 10.1093/database/bav120., Print 2016. PMID:26896845 doi:http://dx.doi.org/10.1093/database/bav120


Pagel, J. F., & Parnes, B. L. (2001). Medications for the Treatment of Sleep Disorders: An Overview. Primary Care Companion to The Journal of Clinical Psychiatry, 3(3), 118–125.

Schwartz, J. R. ., & Roth, T. (2008). Neurophysiology of Sleep and Wakefulness: Basic Science and Clinical Implications. Current Neuropharmacology, 6(4), 367–378. http://doi.org/10.2174/157015908787386050

Sutton, E. L. (2015). Profile of suvorexant in the management of insomnia. Drug Design, Development and Therapy, 9, 6035–6042. http://doi.org/10.2147/DDDT.S73224

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